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General NPI Number Information
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NPI Number | 1538396312
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Entity Type | Organization
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Legal Business Name | WATER'S EDGE TRANSPORTATION, LLC
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 06/18/2009
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Provider Practice Location Address
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Address Line | 380 INDUSTRIAL BLVD
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City | WACONIA
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State | MN
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Zip | 55387-1738
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Country | US
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Telephone | 952-442-7022
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Fax | 952-442-9022
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Provider Business Mailing Address
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Address Line | 380 INDUSTRIAL BLVD
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City | WACONIA
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State | MN
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Zip | 55387-1738
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Country | US
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Telephone | 952-442-7022
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Fax | 952-442-9022
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. JODI ANN MORSCHEN
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Credential |
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Telephone | 952-442-7022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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