Provider Demographics
NPI:1073994430
Name:MERLS TRANSPORTATION
Entity Type:Organization
Organization Name:MERLS TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:LAMBUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-224-6918
Mailing Address - Street 1:434 14TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-3941
Mailing Address - Country:US
Mailing Address - Phone:320-240-8386
Mailing Address - Fax:
Practice Address - Street 1:434 14TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-3941
Practice Address - Country:US
Practice Address - Phone:320-240-8386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN381142343900000X
347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle