Provider Demographics
NPI:1760919393
Name:FAMILY TRANSPORT LLC.,
Entity Type:Organization
Organization Name:FAMILY TRANSPORT LLC.,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RANGEL-SOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-383-8138
Mailing Address - Street 1:1201 S 50TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53214-3533
Mailing Address - Country:US
Mailing Address - Phone:414-383-8138
Mailing Address - Fax:
Practice Address - Street 1:1201 S 50TH ST
Practice Address - Street 2:
Practice Address - City:WEST MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53214-3533
Practice Address - Country:US
Practice Address - Phone:414-383-8138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-13
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)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100036762Medicaid