Provider Demographics
NPI:1538371513
Name:NORTHLAND TRANSPORTATION, INC.
Entity type:Organization
Organization Name:NORTHLAND TRANSPORTATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-922-6876
Mailing Address - Street 1:7210 154TH ST W
Mailing Address - Street 2:
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372-9777
Mailing Address - Country:US
Mailing Address - Phone:952-922-6876
Mailing Address - Fax:952-846-0393
Practice Address - Street 1:11990 RIVERWOOD DR
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-1505
Practice Address - Country:US
Practice Address - Phone:952-922-6876
Practice Address - Fax:952-846-0393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1111648343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN36481OtherHEALTHPARTNERS
MN590568100Medicaid
MN102019OtherUCARE
MN810003OtherMEDICA
MN3G609NOOtherBLUE CROSS