Provider Demographics
NPI:1346690542
Name:VANGUARD TRANSPORTATION SERVICE, INC
Entity Type:Organization
Organization Name:VANGUARD TRANSPORTATION SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-528-0725
Mailing Address - Street 1:2160 COUNTY ROAD E W APT 205
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-7192
Mailing Address - Country:US
Mailing Address - Phone:651-528-0725
Mailing Address - Fax:651-330-2885
Practice Address - Street 1:2160 COUNTY ROAD E W APT 205
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-7192
Practice Address - Country:US
Practice Address - Phone:651-528-0725
Practice Address - Fax:651-330-2885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-18
Last Update Date:2016-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNB542021457611347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle