Provider Demographics
NPI:1730552670
Name:SOMA TRANSPORTATION CO
Entity type:Organization
Organization Name:SOMA TRANSPORTATION CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:INTISAR
Authorized Official - Middle Name:S
Authorized Official - Last Name:GEIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-646-8111
Mailing Address - Street 1:393 DUNLAP ST N
Mailing Address - Street 2:STE 450
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4200
Mailing Address - Country:US
Mailing Address - Phone:651-646-8111
Mailing Address - Fax:651-644-2088
Practice Address - Street 1:393 DUNLAP ST N
Practice Address - Street 2:STE 450
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4200
Practice Address - Country:US
Practice Address - Phone:651-646-8111
Practice Address - Fax:651-644-2088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-31
Last Update Date:2015-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN371738343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN=========Medicaid