Provider Demographics
NPI:1962037424
Name:GLORY TRANSPORTATION SERVICES LLC
Entity Type:Organization
Organization Name:GLORY TRANSPORTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:414-416-1232
Mailing Address - Street 1:8701 W GREENWOOD TER
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224-4019
Mailing Address - Country:US
Mailing Address - Phone:414-416-1232
Mailing Address - Fax:414-236-5209
Practice Address - Street 1:8701 W GREENWOOD TER
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53224-4019
Practice Address - Country:US
Practice Address - Phone:414-416-1232
Practice Address - Fax:414-236-5209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)