Healthcare Provider Details

I. General information

NPI: 1922766591
Provider Name (Legal Business Name): MKE EXPEDITED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2021
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 W BELOIT RD STE 106
MILWAUKEE WI
53227-4357
US

IV. Provider business mailing address

9401 W BELOIT RD STE 106
MILWAUKEE WI
53227-4357
US

V. Phone/Fax

Practice location:
  • Phone: 414-436-4400
  • Fax:
Mailing address:
  • Phone: 414-436-4400
  • 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
# 3
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: DEJAN DRCA
Title or Position: CEO
Credential:
Phone: 414-436-4400