Provider Demographics
NPI:1679743736
Name:SOUTHDALE TRANSPORTATION SERVICES, INC.
Entity type:Organization
Organization Name:SOUTHDALE TRANSPORTATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NUR
Authorized Official - Middle Name:S
Authorized Official - Last Name:SAYID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-332-8990
Mailing Address - Street 1:PO BOX 582799
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55458-2799
Mailing Address - Country:US
Mailing Address - Phone:612-332-8990
Mailing Address - Fax:612-332-8993
Practice Address - Street 1:7200 FRANCE AVE S STE 333
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4310
Practice Address - Country:US
Practice Address - Phone:612-332-8990
Practice Address - Fax:612-332-8993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN371708343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)