Provider Demographics
NPI:1376630434
Name:CAPITOL EXPRESS TRANSPORTATION
Entity Type:Organization
Organization Name:CAPITOL EXPRESS TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRANCEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-834-9331
Mailing Address - Street 1:918 WATSON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-3276
Mailing Address - Country:US
Mailing Address - Phone:608-661-7433
Mailing Address - Fax:608-271-6151
Practice Address - Street 1:918 WATSON AVE STE 201
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-3276
Practice Address - Country:US
Practice Address - Phone:608-661-7433
Practice Address - Fax:608-271-6151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41490100Medicaid