Provider Demographics
NPI:1639376700
Name:ARBOR TRANSPORTATION
Entity Type:Organization
Organization Name:ARBOR TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BLAISE
Authorized Official - Middle Name:G
Authorized Official - Last Name:HUBERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-923-4400
Mailing Address - Street 1:PO BOX 811
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54936-0811
Mailing Address - Country:US
Mailing Address - Phone:920-923-4400
Mailing Address - Fax:
Practice Address - Street 1:609 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:NORTH FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54937-1317
Practice Address - Country:US
Practice Address - Phone:920-923-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI08-00002413344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi