Healthcare Provider Details
I. General information
NPI: 1255416350
Provider Name (Legal Business Name): ESPELAND VAN SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
44 6TH AVE SE
WINNEBAGO MN
56098-1074
US
IV. Provider business mailing address
44 6TH AVE SE PO BOX 247
WINNEBAGO MN
56098-1074
US
V. Phone/Fax
- Phone: 507-893-4458
- Fax: 507-893-4447
- Phone: 507-893-4458
- Fax: 507-893-4447
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DANIEL
JAY
ESPELAND
Title or Position: GENERAL MANAGER
Credential:
Phone: 507-893-4458