Healthcare Provider Details

I. General information

NPI: 1457062986
Provider Name (Legal Business Name): REFENEL LOGISTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2022
Last Update Date: 12/20/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3588 GARDEN BLVD N
SAINT PAUL MN
55128-3116
US

IV. Provider business mailing address

3588 GARDEN BLVD N
SAINT PAUL MN
55128-3116
US

V. Phone/Fax

Practice location:
  • Phone: 651-747-5685
  • Fax:
Mailing address:
  • Phone: 651-747-5685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NAOMI GITHONGO
Title or Position: OWNER
Credential:
Phone: 651-747-5685