MEDICARE: CMK TRANSPORTATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1447922125
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CMK TRANSPORTATION

Provider Business Mailing Address
First Line	:	333 W BROWN DEER RD STE G
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53217-2370
Country	:	US
Telephone Number	:	601-316-1556
Fax Number	:

Provider Business Practice Location Address
First Line	:	8625 W FAIRY CHASM DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53224-1811
Country	:	US
Telephone Number	:	601-316-1556
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ROMERRA TAYLOR
Credential	:
Telephone Number	:	601-316-1556

Provider Enumeration Date	:	10/01/2021
Last Update Date	:	10/03/2021

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Directions to “CMK TRANSPORTATION ” Practice Location

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