MEDICARE: A&R TRANSPORT SERVICE LLC

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	:	1881303311
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A&R TRANSPORT SERVICE LLC

Provider Business Mailing Address
First Line	:	3489 N 76TH ST STE 202
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-3968
Country	:	US
Telephone Number	:	414-630-8855
Fax Number	:

Provider Business Practice Location Address
First Line	:	3489 N 76TH ST STE 202
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-3968
Country	:	US
Telephone Number	:	414-630-8855
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. RAVEN SYMONE GRAVES
Credential	:	BS
Telephone Number	:	414-630-8855

Provider Enumeration Date	:	11/23/2022
Last Update Date	:	11/29/2022

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