MEDICARE: TREX TRANSPORTATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1417804717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TREX TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	1555 OSTERGAARD AVE
Second Line	:
City	:	RACINE
State	:	WI
Zip	:	53406-4539
Country	:	US
Telephone Number	:	262-383-0655
Fax Number	:

Provider Business Practice Location Address
First Line	:	1555 OSTERGAARD AVE
Second Line	:
City	:	RACINE
State	:	WI
Zip	:	53406-4539
Country	:	US
Telephone Number	:	262-383-0655
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KRISTY HOLLIBUSH
Credential	:
Telephone Number	:	262-383-0655

Provider Enumeration Date	:	03/14/2026
Last Update Date	:	03/14/2026

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