Healthcare Provider Details

I. General information

NPI: 1649613209
Provider Name (Legal Business Name): TRANBYHEALTHRIDE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2013
Last Update Date: 04/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9306 1ST AVE S
BLOOMINGTON MN
55420-3704
US

IV. Provider business mailing address

9306 1ST AVE S
BLOOMINGTON MN
55420-3704
US

V. Phone/Fax

Practice location:
  • Phone: 952-854-5007
  • Fax: 954-854-5070
Mailing address:
  • Phone: 952-854-5007
  • Fax: 954-854-5070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number2384746
License Number StateMN

VIII. Authorized Official

Name: MR. JOSEPH OLE TRANBY II
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 952-854-5007