Provider Demographics
NPI:1740414986
Name:POE'S TRANSIT
Entity Type:Organization
Organization Name:POE'S TRANSIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:POE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-833-2211
Mailing Address - Street 1:40 LAKEVIEW ST
Mailing Address - Street 2:
Mailing Address - City:WOLF LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:62998-1000
Mailing Address - Country:US
Mailing Address - Phone:573-429-7513
Mailing Address - Fax:618-833-8910
Practice Address - Street 1:40 LAKEVIEW ST
Practice Address - Street 2:
Practice Address - City:WOLF LAKE
Practice Address - State:IL
Practice Address - Zip Code:62998-1000
Practice Address - Country:US
Practice Address - Phone:573-429-7513
Practice Address - Fax:618-833-8910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL10393PT343800000X
IL10347PT343900000X
IL10348PT343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)