Healthcare Provider Details

I. General information

NPI: 1073630919
Provider Name (Legal Business Name): HANDI-VAN TRANSPORT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43702 102ND AVE SW
FERTILE MN
56540-9192
US

IV. Provider business mailing address

43702 102ND AVE SW
FERTILE MN
56540-9192
US

V. Phone/Fax

Practice location:
  • Phone: 218-945-6655
  • Fax:
Mailing address:
  • Phone: 218-945-6655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number153684
License Number StateMN

VIII. Authorized Official

Name: MRS. BELINDA LAURICE FJELD
Title or Position: GENERAL PARTNER
Credential:
Phone: 218-945-6655