Provider Demographics
NPI:1043914922
Name:WESTERN BRIDGE TRANSPORT, LLC
Entity Type:Organization
Organization Name:WESTERN BRIDGE TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMCEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-687-9455
Mailing Address - Street 1:4320 MINDI AVE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-6742
Mailing Address - Country:US
Mailing Address - Phone:239-243-9511
Mailing Address - Fax:
Practice Address - Street 1:4320 MINDI AVE
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-6742
Practice Address - Country:US
Practice Address - Phone:239-243-9511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)