Healthcare Provider Details

I. General information

NPI: 1144111238
Provider Name (Legal Business Name): VOYAGE ELITES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W153N9707 NEPTUNE DR
GERMANTOWN WI
53022-5215
US

IV. Provider business mailing address

6825 W BROWN DEER RD UNIT 241986
MILWAUKEE WI
53224-6093
US

V. Phone/Fax

Practice location:
  • Phone: 414-699-9034
  • Fax:
Mailing address:
  • Phone: 414-699-9034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MRS. IYAKU TERRELL-RUSS
Title or Position: OWNER
Credential:
Phone: 414-699-9034