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General NPI Number Information
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NPI Number | 1043914922
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Entity Type | Organization
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Legal Business Name | WESTERN BRIDGE TRANSPORT, LLC
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Dates
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Enumeration Date | 03/27/2023
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 4320 MINDI AVE
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City | NAPLES
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State | FL
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Zip | 34112-6742
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Country | US
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Telephone | 239-243-9511
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Fax |
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Provider Business Mailing Address
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Address Line | 4320 MINDI AVE
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City | NAPLES
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State | FL
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Zip | 34112-6742
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Country | US
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Telephone | 239-243-9511
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MR. JOHNY WILLIAMCEAU
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Credential |
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Telephone | 239-687-9455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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