Provider Demographics
NPI:1780029256
Name:CARE CALL VAN SERVICE
Entity Type:Organization
Organization Name:CARE CALL VAN SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKLUND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-817-0208
Mailing Address - Street 1:PO BOX 216
Mailing Address - Street 2:
Mailing Address - City:ROTHSAY
Mailing Address - State:MN
Mailing Address - Zip Code:56579-0216
Mailing Address - Country:US
Mailing Address - Phone:218-867-2749
Mailing Address - Fax:218-867-2769
Practice Address - Street 1:2025 W ALCOTT AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2655
Practice Address - Country:US
Practice Address - Phone:218-867-2749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN377262343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA528918400Medicaid