Provider Demographics
NPI:1346649795
Name:WILSON ASSISTED TRANSPORTATION INC.
Entity Type:Organization
Organization Name:WILSON ASSISTED TRANSPORTATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-282-5918
Mailing Address - Street 1:1425 BALMORAL DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48203-1442
Mailing Address - Country:US
Mailing Address - Phone:313-282-5918
Mailing Address - Fax:313-368-7318
Practice Address - Street 1:1425 BALMORAL DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48203-1442
Practice Address - Country:US
Practice Address - Phone:313-282-5918
Practice Address - Fax:313-368-7318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL1908343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)