National Provider Identifier Database

BOOMER RIDE
Private Vehicle

An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.


Contact Information

BOOMER RIDE
724 5TH ST W APT B
HASTINGS, MN55033-1745
Phone: 651-263-0189
Fax:
Website:
Specialty Taxonomy Code
* Private Vehicle 347C00000X

* Indicates primary specialty

NPI Profile & details for BOOMER RIDE

NPI Number 1194121210
Legal business name
LBN
BOOMER RIDE
Authorized official LESLIE HOWARD - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 11/17/2014
Last updated 11/17/2014 - About 12 years ago
Sole proprietor1 Not specified
Identifiers
  • MN License #: C893012006120

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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