Provider Demographics
NPI:1548878382
Name:AMERICAN PHOENIX TRANSPORTATION LLC
Entity type:Organization
Organization Name:AMERICAN PHOENIX TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-271-0201
Mailing Address - Street 1:8544 9 MILE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FALL CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:54742-5306
Mailing Address - Country:US
Mailing Address - Phone:715-895-7555
Mailing Address - Fax:715-895-7555
Practice Address - Street 1:8544 9 MILE CREEK RD
Practice Address - Street 2:
Practice Address - City:FALL CREEK
Practice Address - State:WI
Practice Address - Zip Code:54742-5306
Practice Address - Country:US
Practice Address - Phone:715-895-7555
Practice Address - Fax:715-895-7555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)