Provider Demographics
NPI:1013687326
Name:WI AND BEYOND TRANSPORT LLC
Entity Type:Organization
Organization Name:WI AND BEYOND TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:T
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-577-1542
Mailing Address - Street 1:7647 SUFFOLK DOWN
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-9522
Mailing Address - Country:US
Mailing Address - Phone:608-577-1542
Mailing Address - Fax:
Practice Address - Street 1:7647 SUFFOLK DOWN
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-9522
Practice Address - Country:US
Practice Address - Phone:608-577-1542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AND BEYOND TRANSPORT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)