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General NPI Number Information
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NPI Number | 1538409222
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Entity Type | Organization
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Legal Business Name | MCGOWAN TRANSPORT SERVICES
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Dates
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Enumeration Date | 02/18/2013
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Last Update Date | 02/18/2013
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Provider Practice Location Address
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Address Line | 4429 W FOND DU LAC AVE
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City | MILWAUKEE
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State | WI
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Zip | 53216-3444
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Country | US
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Telephone | 414-459-3319
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Fax | 414-444-4810
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Provider Business Mailing Address
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Address Line | 4429 W FOND DU LAC AVE
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City | MILWAUKEE
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State | WI
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Zip | 53216-3444
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Country | US
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Telephone | 414-459-3319
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Fax | 414-444-4810
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HENRY CLAY MCGOWAN III
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Credential |
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Telephone | 414-459-3319
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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 | E802BBBTKL
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License Number State | WI
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