Healthcare Provider Details

I. General information

NPI: 1619642501
Provider Name (Legal Business Name): KOZY TRANSPORT SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2021
Last Update Date: 08/12/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5853 PLEASANT LN
SAINT CLOUD MN
56303-0622
US

IV. Provider business mailing address

5853 PLEASANT LN
SAINT CLOUD MN
56303-0622
US

V. Phone/Fax

Practice location:
  • Phone: 320-293-8930
  • Fax:
Mailing address:
  • Phone: 320-293-8930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: THOMAS A HIIVALA
Title or Position: PRESIDENT
Credential:
Phone: 320-293-8930