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General NPI Number Information
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NPI Number | 1649050402
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Entity Type | Organization
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Legal Business Name | EDWARDS RIDECARE INC.
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Dates
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Enumeration Date | 09/29/2023
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 7809 SOUTHTOWN CTR UNIT 408
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City | BLOOMINGTON
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State | MN
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Zip | 55431-1324
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Country | US
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Telephone | 800-674-9816
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Fax |
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Provider Business Mailing Address
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Address Line | 7809 SOUTHTOWN CTR UNIT 408
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City | BLOOMINGTON
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State | MN
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Zip | 55431-1324
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Country | US
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Telephone | 800-674-9816
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | KEVIN A SPANBAUER
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Credential |
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Telephone | 952-250-0836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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