Provider Demographics
NPI:1932642881
Name:EXPRESS TRANSIT INC.
Entity Type:Organization
Organization Name:EXPRESS TRANSIT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SURAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:TIWARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-343-4609
Mailing Address - Street 1:3707 N RICHARDS ST STE 214
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-1675
Mailing Address - Country:US
Mailing Address - Phone:262-343-4609
Mailing Address - Fax:414-751-7631
Practice Address - Street 1:3707 N RICHARDS ST STE 214
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-1675
Practice Address - Country:US
Practice Address - Phone:262-343-4609
Practice Address - Fax:414-751-7631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-27
Last Update Date:2016-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100058694Medicaid