Organization
TLC SPECIAL TRANSPORTATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BORIS AVERBAKH (PRESIDENT)
(952) 882-0535
Entity
Organization
Contact information
Practice address
900 W 128TH STREET, BURNSVILLE, MN 55337
(952) 882-0535
(952) 882-0571
Mailing address
900 W 128TH STREET, BURNSVILLE, MN 55337
(952) 882-0535
(952) 882-0571
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
STS153668
MN
Other
Enumeration date
10/03/2006
Last updated
08/22/2020
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