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General NPI Number Information
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NPI Number | 1669014221
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Entity Type | Organization
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Legal Business Name | WESTPORT MEDICAL TRANSPORTATION
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Dates
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Enumeration Date | 10/15/2019
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Last Update Date | 10/15/2019
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Provider Practice Location Address
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Address Line | 8918 WESTPORT RD
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City | LOUISVILLE
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State | KY
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Zip | 40242-3221
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Country | US
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Telephone | 502-639-7670
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Fax | 502-709-9807
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Provider Business Mailing Address
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Address Line | 500 ENVOY CIR STE 500
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City | LOUISVILLE
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State | KY
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Zip | 40299-2887
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Country | US
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Telephone | 502-639-7670
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Fax | 502-709-9807
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Authorized Official
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Title or Position | OWNER
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Name | MR. CURTIS WIGGINS
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Credential |
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Telephone | 502-639-7670
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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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