Healthcare Provider Details

I. General information

NPI: 1265399034
Provider Name (Legal Business Name): COMPASS CARE TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1953 169TH AVE NE
HAM LAKE MN
55304-4908
US

IV. Provider business mailing address

1953 169TH AVE NE
HAM LAKE MN
55304-4908
US

V. Phone/Fax

Practice location:
  • Phone: 763-464-6786
  • Fax: 763-464-6786
Mailing address:
  • Phone: 763-464-6786
  • Fax: 763-464-6786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MARK STATI
Title or Position: CEO
Credential:
Phone: 763-464-6786