Provider Demographics
NPI:1427281088
Name:ACTIVE TRANSPORTATION SERVICES INC.
Entity type:Organization
Organization Name:ACTIVE TRANSPORTATION SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN. ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-588-1014
Mailing Address - Street 1:1834 EMERSON AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-3229
Mailing Address - Country:US
Mailing Address - Phone:612-588-1014
Mailing Address - Fax:612-522-0953
Practice Address - Street 1:1834 EMERSON AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-3229
Practice Address - Country:US
Practice Address - Phone:612-588-1014
Practice Address - Fax:612-522-0953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN373215343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)