Provider Demographics
NPI:1790105161
Name:ENDLE
Entity Type:Organization
Organization Name:ENDLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:STAVIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-625-2485
Mailing Address - Street 1:321 19TH AVE S
Mailing Address - Street 2:SUITE 2-212
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0438
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:321 19TH AVE S
Practice Address - Street 2:SUITE 2-212
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0438
Practice Address - Country:US
Practice Address - Phone:612-625-2485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies