Healthcare Provider Details

I. General information

NPI: 1336023449
Provider Name (Legal Business Name): ACCESS VALLEY TRANSPORT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2025
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 E BYRD ST
APPLETON WI
54911-3018
US

IV. Provider business mailing address

1315 E BYRD ST
APPLETON WI
54911-3018
US

V. Phone/Fax

Practice location:
  • Phone: 608-722-0002
  • Fax:
Mailing address:
  • Phone: 608-722-0002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: SAMATAR OMAR ABDI
Title or Position: MANAGER
Credential: MR
Phone: 608-722-0002