Organization
HEALTH RIDE VAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATE MEYER (CHIEF FINANCIAL OFFICE)
(218) 847-5611
Entity
Organization
Contact information
Practice address
1240 WASHINGTON AVE, DETROIT LAKES, MN 56501-3906
(218) 847-0817
(218) 847-0842
Mailing address
PO BOX 1410, DETROIT LAKES, MN 56502-1410
(218) 847-0817
(218) 847-0842
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
198222
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51792
—
ND
01
—
81-20881
MEDICA
MN
01
—
9G009MA
BCBS OF MINNESOTA
MN
Enumeration date
08/31/2006
Last updated
08/22/2020
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