Express Transportation of Wi, LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

100005686 Issued in WI

Legal business name

EXPRESS TRANSPORTATION OF WI, LLC

Practice address

9675 S 54TH St
Franklin, WI 53132-9825

Phone

(414) 235-3668

Fax

(414) 235-4933

NPI assigned

Apr 5, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David Devereaux

Title

Co-Owner

Phone

(414) 235-3668

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270425600000",
    "number": "1306161252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9675 S 54TH ST",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531329825",
            "telephone_number": "414-235-3668",
            "fax_number": "414-235-4933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9675 S 54TH ST",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531329825",
            "telephone_number": "414-235-3668",
            "fax_number": "414-235-4933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS TRANSPORTATION OF WI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-05",
        "last_updated": "2010-04-05",
        "status": "A",
        "authorized_official_last_name": "DEVEREAUX",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "414-235-3668",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "WI",
            "license": "100005686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100005686",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Kae Ellis
• EMS Observation, S.C.
• Austen Eppen
• Tammy L Ertl, NP
• Exos Wi LLC
• Allison Louise Fabrocino
• Claire Fadness, RD
• Chan'Tel Fair
• Saba Farooqui
• Kelly Fausek, PHARMD.

• Non-emergency Medical Transport (VAN) in Franklin, WI
• Providers in Franklin, WI by specialty
• Non-emergency Medical Transport (VAN) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.