Provider Demographics
NPI:1659082329
Name:XTREME ENTERPRISES INC.
Entity type:Organization
Organization Name:XTREME ENTERPRISES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-547-2929
Mailing Address - Street 1:748 DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-2460
Mailing Address - Country:US
Mailing Address - Phone:913-651-9274
Mailing Address - Fax:
Practice Address - Street 1:63 VANTAGE PT
Practice Address - Street 2:
Practice Address - City:MIRAMAR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32550-4864
Practice Address - Country:US
Practice Address - Phone:850-502-3716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:XTREME ENTERPRISES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-13
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)