MEDICARE: RIIDE MINNEAPOLIS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1124536610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIIDE MINNEAPOLIS, INC

Provider Business Mailing Address
First Line	:	4808 PARK GLEN RD
Second Line	:
City	:	SAINT LOUIS PARK
State	:	MN
Zip	:	55416-5702
Country	:	US
Telephone Number	:	612-333-0918
Fax Number	:

Provider Business Practice Location Address
First Line	:	4808 PARK GLEN RD
Second Line	:
City	:	SAINT LOUIS PARK
State	:	MN
Zip	:	55416-5702
Country	:	US
Telephone Number	:	612-333-0918
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MRS. HEIDI L LEPPALA
Credential	:
Telephone Number	:	612-333-0918

Provider Enumeration Date	:	01/18/2018
Last Update Date	:	01/18/2018

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