Provider Demographics
NPI:1760796403
Name:COMMUNITY TRANSPORTATION
Entity Type:Organization
Organization Name:COMMUNITY TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWREN
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-770-7689
Mailing Address - Street 1:5429 NORTH 106TH STREET
Mailing Address - Street 2:
Mailing Address - City:MILWUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-3207
Mailing Address - Country:US
Mailing Address - Phone:262-770-7689
Mailing Address - Fax:
Practice Address - Street 1:5429 N 106TH STREET
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53225-3207
Practice Address - Country:US
Practice Address - Phone:262-770-7689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)