Organization
AZURE RIDE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONES BITANGE (CEO)
(763) 537-9333
Entity
Organization
Contact information
Practice address
6000 BASS LAKE RD, CRYSTAL, MN 55429-2700
(763) 537-9333
Mailing address
6000 BASS LAKE RD, CRYSTAL, MN 55429-2700
(763) 537-9333
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4144
MEDICAL TRANSPORTATION
MN
Enumeration date
10/12/2015
Last updated
10/12/2015
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