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General NPI Number Information
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NPI Number | 1255005393
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Entity Type | Organization
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Legal Business Name | ANT TRANSPORT8 LLC
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 08/03/2021
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Provider Practice Location Address
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Address Line | 5910 77TH ST STE A
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City | KENOSHA
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State | WI
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Zip | 53142-4104
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Country | US
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Telephone | 262-344-0494
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Fax | 262-764-3441
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Provider Business Mailing Address
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Address Line | 5910 77TH ST STE A
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City | KENOSHA
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State | WI
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Zip | 53142-4104
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Country | US
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Telephone | 262-344-0494
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Fax | 262-764-3441
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Authorized Official
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Title or Position | OWNER/OPERATION
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Name | TERINA ELIZABETH NELSON
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Credential |
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Telephone | 262-764-3441
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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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