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NPI Code Detail

MEDICARE: HERITAGE TRANSPORTATION, INC.

MEDICARE: HERITAGE TRANSPORTATION, 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
1343900000XNon-emergency Medical Transport (VAN)

General Provider Information

NPI Number : 1932576238
Entity Type Code : Organization
Provider Name (Legal Business Name) : HERITAGE TRANSPORTATION, INC.
Provider Business Mailing Address
First Line : 4103 E LAKE ST
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-2259
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4103 E LAKE ST
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-2259
Country : US
Telephone Number : 612-728-8080
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DANIEL LM KENNEDY
Credential :
Telephone Number : 612-728-8080
Provider Enumeration Date : 08/21/2015
Last Update Date : 08/21/2015

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Directions to “HERITAGE TRANSPORTATION, INC. ” Practice Location

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