Healthcare Provider Details

I. General information

NPI: 1285082875
Provider Name (Legal Business Name): BAKER TRANSPORTATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2016
Last Update Date: 05/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 30TH AVE N
SAINT CLOUD MN
56303-3136
US

IV. Provider business mailing address

630 30TH AVE N
SAINT CLOUD MN
56303-3136
US

V. Phone/Fax

Practice location:
  • Phone: 320-240-2999
  • Fax:
Mailing address:
  • Phone: 320-240-2999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number75188
License Number StateMN

VIII. Authorized Official

Name: WILLIAM B BAKER
Title or Position: CEO
Credential:
Phone: 320-237-5905