Provider Demographics
NPI:1043196819
Name:GOODTIME LLC
Entity type:Organization
Organization Name:GOODTIME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VIKTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:TSEONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-273-0521
Mailing Address - Street 1:21235 COMMERCE BLVD APT 102
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:MN
Mailing Address - Zip Code:55374-9338
Mailing Address - Country:US
Mailing Address - Phone:763-273-0521
Mailing Address - Fax:
Practice Address - Street 1:21235 COMMERCE BLVD APT 102
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:MN
Practice Address - Zip Code:55374-9338
Practice Address - Country:US
Practice Address - Phone:763-273-0521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)