Provider Demographics
NPI:1952648800
Name:WHEELS FOR WHEELS TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:WHEELS FOR WHEELS TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHAUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAJEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-722-4638
Mailing Address - Street 1:5107 N SHORE DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55804-2924
Mailing Address - Country:US
Mailing Address - Phone:218-722-4638
Mailing Address - Fax:
Practice Address - Street 1:5107 N SHORE DR
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55804-2924
Practice Address - Country:US
Practice Address - Phone:218-722-4638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2367270343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN037994815OtherDATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER PROVIDED BY DUN AND BRADSTREET (D&
MNA16044200Medicaid