Provider Demographics
NPI:1649050402
Name:EDWARDS RIDECARE INC.
Entity type:Organization
Organization Name:EDWARDS RIDECARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPANBAUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-250-0836
Mailing Address - Street 1:7809 SOUTHTOWN CTR UNIT 408
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-1324
Mailing Address - Country:US
Mailing Address - Phone:800-674-9816
Mailing Address - Fax:
Practice Address - Street 1:7809 SOUTHTOWN CTR UNIT 408
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-1324
Practice Address - Country:US
Practice Address - Phone:800-674-9816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle