=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174253827
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KEEPING IT MOVING TRANSPORTATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2022
-----------------------------------------------------
Last Update Date | 06/15/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4241 N 72ND ST
-----------------------------------------------------
City | MILWAUKEE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53216-1037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-397-7055
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4241 N 72ND ST
-----------------------------------------------------
City | MILWAUKEE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53216-1037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-397-7055
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. MARQUES STAFFORD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 414-397-7055
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2278P4000X
-----------------------------------------------------
Taxonomy Name | Patient Transport Certified Respiratory Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------