=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992994552
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DCS TRANSPORT SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/19/2007
-----------------------------------------------------
Last Update Date | 10/19/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8436 W LISBON AVE
-----------------------------------------------------
City | MILWAUKEE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53222-3768
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-461-8622
-----------------------------------------------------
Fax | 414-461-8624
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8436 W LISBON AVE
-----------------------------------------------------
City | MILWAUKEE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53222-3768
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-461-8622
-----------------------------------------------------
Fax | 414-461-8624
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. JIM MORGAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 414-461-8622
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------