Provider Demographics
NPI:1982010997
Name:WAAGE CONSTRUCTION INCORPORATED
Entity Type:Organization
Organization Name:WAAGE CONSTRUCTION INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WAAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-482-9588
Mailing Address - Street 1:19449 ROCHESTER ST NE
Mailing Address - Street 2:
Mailing Address - City:EAST BETHEL
Mailing Address - State:MN
Mailing Address - Zip Code:55011-4401
Mailing Address - Country:US
Mailing Address - Phone:763-482-9588
Mailing Address - Fax:
Practice Address - Street 1:19449 ROCHESTER ST NE
Practice Address - Street 2:
Practice Address - City:EAST BETHEL
Practice Address - State:MN
Practice Address - Zip Code:55011-4401
Practice Address - Country:US
Practice Address - Phone:763-482-9588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNBC630196171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty