Provider Demographics
NPI:1528642469
Name:WI TRANSPORTATION LLC
Entity type:Organization
Organization Name:WI TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:THAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-758-3287
Mailing Address - Street 1:W143N5009 BROOK FALLS DR
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-6987
Mailing Address - Country:US
Mailing Address - Phone:414-758-3287
Mailing Address - Fax:
Practice Address - Street 1:12714 W HAMPTON AVE STE F
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:WI
Practice Address - Zip Code:53007-1640
Practice Address - Country:US
Practice Address - Phone:414-758-3287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)