Organization
NORTHOME-TEALWOOD TRANSPORTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOWIE GROFF (PRESIDENT)
(952) 888-2923
Entity
Organization
Contact information
Practice address
11995 MAIN STREET, NORTHOME, MN 56661
(218) 897-5235
Mailing address
11995 MAIN STREET, NORTHOME, MN 56661
(218) 897-5235
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123157
UCARE
MN
01
—
12G08TE
BCBS
MN
01
—
8120872
MEDICA
MN
Enumeration date
02/20/2007
Last updated
08/22/2020
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