Provider Demographics
NPI:1629732094
Name:COMPLIMENTARY TRANSPORTATION SERVICE LLC
Entity Type:Organization
Organization Name:COMPLIMENTARY TRANSPORTATION SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-394-0241
Mailing Address - Street 1:8610 W POTOMAC AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-4138
Mailing Address - Country:US
Mailing Address - Phone:414-841-7711
Mailing Address - Fax:
Practice Address - Street 1:8610 W POTOMAC AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53225-4138
Practice Address - Country:US
Practice Address - Phone:414-841-7711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date: