Healthcare Provider Details

I. General information

NPI: 1629681663
Provider Name (Legal Business Name): TAYLOR TRANSPORT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 08/28/2020
Certification Date: 08/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4433 N 50TH ST
MILWAUKEE WI
53218-5704
US

IV. Provider business mailing address

PO BOX 90451
MILWAUKEE WI
53209-0451
US

V. Phone/Fax

Practice location:
  • Phone: 262-488-2746
  • Fax:
Mailing address:
  • Phone: 262-385-6698
  • 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: MR. ANTHONY TAYLOR
Title or Position: CEO
Credential: HIPPA AWARENESS
Phone: 262-385-6698