Provider Demographics
NPI:1417403635
Name:HANDI-XPRESS
Entity Type:Organization
Organization Name:HANDI-XPRESS
Other - Org Name:HANDI-XPRESS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGGENKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-297-0633
Mailing Address - Street 1:204 CLARK ST N
Mailing Address - Street 2:
Mailing Address - City:DEER CREEK
Mailing Address - State:MN
Mailing Address - Zip Code:56527
Mailing Address - Country:US
Mailing Address - Phone:320-297-0633
Mailing Address - Fax:218-462-6802
Practice Address - Street 1:204 CLARK ST N
Practice Address - Street 2:
Practice Address - City:DEER CREEK
Practice Address - State:MN
Practice Address - Zip Code:56527
Practice Address - Country:US
Practice Address - Phone:320-297-0633
Practice Address - Fax:218-462-6802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-28
Last Update Date:2017-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNSTS 382118343900000X
MN75362343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)