Healthcare Provider Details

I. General information

NPI: 1518964337
Provider Name (Legal Business Name): CRITICAL CARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 04/29/2024
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4188 LEXINGTON AVENUE N
SHOREVIEW MN
55126
US

IV. Provider business mailing address

3673 LEXINGTON AVE N SUITE H-2, BOX 402
ARDEN HILLS MN
55126
US

V. Phone/Fax

Practice location:
  • Phone: 612-638-4900
  • Fax: 612-638-4906
Mailing address:
  • Phone: 612-638-4900
  • Fax: 612-638-4906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number0360
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0359
License Number StateMN
# 4
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number6011349
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0357
License Number StateMN
# 6
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number324262
License Number StateMN

VIII. Authorized Official

Name: LISA M KNIPPING
Title or Position: CFO
Credential:
Phone: 612-638-4900