Healthcare Provider Details

I. General information

NPI: 1124346606
Provider Name (Legal Business Name): BAY AREA RURAL TRANSIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2010
Last Update Date: 05/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 INDUSTRIAL PARK ROAD
ASHLAND WI
54806-0612
US

IV. Provider business mailing address

PO BOX 612 300 INDUSTRIAL PARK ROAD
ASHLAND WI
54806-0612
US

V. Phone/Fax

Practice location:
  • Phone: 715-682-9664
  • Fax: 712-682-5570
Mailing address:
  • Phone: 715-682-9664
  • Fax: 712-682-5570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347B00000X
TaxonomyBus
License NumberP.C.1175
License Number StateWI

VIII. Authorized Official

Name: PATRICK D DAOUST
Title or Position: BOOKKEEPER
Credential:
Phone: 715-682-9664