MEDICARE: REFENEL LOGISTICS LLC

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	172A00000X	Driver
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1457062986
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REFENEL LOGISTICS LLC

Provider Business Mailing Address
First Line	:	3588 GARDEN BLVD N
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55128-3116
Country	:	US
Telephone Number	:	651-747-5685
Fax Number	:

Provider Business Practice Location Address
First Line	:	3588 GARDEN BLVD N
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55128-3116
Country	:	US
Telephone Number	:	651-747-5685
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NAOMI GITHONGO
Credential	:
Telephone Number	:	651-747-5685

Provider Enumeration Date	:	12/06/2022
Last Update Date	:	12/20/2022

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Directions to “REFENEL LOGISTICS LLC ” Practice Location

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