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General NPI Number Information
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NPI Number | 1720140866
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Entity Type | Organization
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Legal Business Name | LAVELLS TRANSPORT INC
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 01/21/2008
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Provider Practice Location Address
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Address Line | 5767 N 98TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53225-2507
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Country | US
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Telephone | 414-464-3686
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Fax | 414-464-5332
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Provider Business Mailing Address
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Address Line | 5767 N 98TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53225-2507
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Country | US
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Telephone | 414-464-3686
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Fax | 414-464-5332
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TORRANCE LAVELL EVANS
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Credential |
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Telephone | 414-464-3686
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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 | 41473200
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License Number State | WI
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