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Organization

PROFICIO ANCILLARY SERVICE PROVIDER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRUCE CAPAGLI (COO)
(952) 562-2900
Entity
Organization

Contact information

Practice address
4445 W 77TH ST STE 208, EDINA, MN 55435-5190
(952) 562-2900
(248) 487-9442
Mailing address
7455 FRANCE AVE S STE 373, EDINA, MN 55435-4702

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
347E00000X
Transportation Broker

Other

Enumeration date
04/18/2023
Last updated
04/18/2023
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