Healthcare Provider Details

I. General information

NPI: 1073994430
Provider Name (Legal Business Name): MERLS TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 06/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 14TH AVE N
SAINT CLOUD MN
56303-3941
US

IV. Provider business mailing address

434 14TH AVE N
SAINT CLOUD MN
56303-3941
US

V. Phone/Fax

Practice location:
  • Phone: 320-240-8386
  • Fax:
Mailing address:
  • Phone: 320-240-8386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number381142
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: ROBERT E LAMBUS
Title or Position: GENERAL MANAGER
Credential:
Phone: 320-224-6918