Organization · NPI-2

Edenwood Transportation LLC

Clinic/Center · Eden Prairie, MN

NPI number1700778891
StatusActive
Last updated in NPPESNov 17, 2025

Details

NPI
1700778891
Entity type
Organization (NPI-2)
Legal business name
Edenwood Transportation LLC
Organization subpart
No
Enumeration date
Jul 15, 2025
Certification date
Nov 17, 2025
Last updated
Nov 17, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

6385 Old Shady Oak Rd Ste 250-231
Eden Prairie, MN 55344-3299

Phone 480-246-0959

Mailing address

6385 Old Shady Oak Rd Ste 250-231
Eden Prairie, MN 55344-3299

Authorized official

Suheib Ali
Owner
4802460959

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