Healthcare Provider Details

I. General information

NPI: 1093145575
Provider Name (Legal Business Name): CARE CAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2013
Last Update Date: 01/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 7TH ST N
SAINT CLOUD MN
56303-3100
US

IV. Provider business mailing address

2600 7TH ST N
SAINT CLOUD MN
56303-3100
US

V. Phone/Fax

Practice location:
  • Phone: 320-253-7729
  • Fax: 320-251-7930
Mailing address:
  • Phone: 320-253-7729
  • Fax: 320-251-7930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number150822
License Number StateMN

VIII. Authorized Official

Name: SUE FOSEID
Title or Position: ADMINISTRATIVE VP
Credential:
Phone: 320-217-6703