Americoach Specialized Transportation, LLC

Key facts

NPI: 1124348222
Entity type: Organization (NPI type 2)
Primary specialty: Non-emergency Medical Transport (VAN) 343900000X
Legal business name: AMERICOACH SPECIALIZED TRANSPORTATION, LLC
Practice address: 3960A N 21St St
Milwaukee, WI 53206-1969
Phone: (414) 231-0465
Fax: (414) 873-3565
NPI assigned: Jun 11, 2010
Organization subpart: No

Authorized official

Name: Mr. Clarence Lee Pierce Jr.
Title: Director
Phone: (414) 231-0465

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Non-emergency Medical Transport (VAN)	343900000X			Yes

Addresses

Primary practice location

3960A N 21St St
Milwaukee, WI 53206-1969

Mailing address

PO Box 1812
Milwaukee, WI 53201-1812
Phone (414) 231-0465

Other identifiers

Identifier	Type	State	Issuer
100004801	Medicaid	WI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 8, 2011.

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307491200000",
    "number": "1124348222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1812",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532011812",
            "telephone_number": "414-231-0465",
            "fax_number": "414-873-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960A N 21ST ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532061969",
            "telephone_number": "414-231-0465",
            "fax_number": "414-873-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICOACH SPECIALIZED TRANSPORTATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-11",
        "last_updated": "2011-06-08",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "414-231-0465",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100004801",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

All providers in Milwaukee, WI · Non-emergency Medical Transport (VAN) in Wisconsin

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.