Organization
ELBRUS EMPIRE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
J EAGLE VANG (MANAGER)
(763) 450-4240
Entity
Organization
Contact information
Practice address
12800 INDUSTRIAL PARK BLVD STE 150B, PLYMOUTH, MN 55441-3949
(763) 450-4240
Mailing address
12800 INDUSTRIAL PARK BLVD STE 150B, PLYMOUTH, MN 55441-3949
(763) 450-4240
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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