Healthcare Provider Details

I. General information

NPI: 1689010241
Provider Name (Legal Business Name): LUCAS TAXI INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2013
Last Update Date: 06/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 GROVE ST SW SUITE A
HUTCHINSON MN
55350-3185
US

IV. Provider business mailing address

870 GROVE ST SW SUITE A
HUTCHINSON MN
55350-3185
US

V. Phone/Fax

Practice location:
  • Phone: 320-552-3148
  • Fax:
Mailing address:
  • Phone: 320-552-3148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateMN

VIII. Authorized Official

Name: MR. JAMES LESLIE LUCAS JR.
Title or Position: CO-OWNER/ PRESIDENT/ CEO
Credential:
Phone: 320-552-3148