Provider Demographics
NPI:1205523297
Name:CLB TRANSPORTATION LLC
Entity type:Organization
Organization Name:CLB TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CANDIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:STATEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-517-9351
Mailing Address - Street 1:2605 N 18TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53206-2049
Mailing Address - Country:US
Mailing Address - Phone:414-998-8420
Mailing Address - Fax:
Practice Address - Street 1:807 E JUNEAU AVE APT 7
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2751
Practice Address - Country:US
Practice Address - Phone:414-998-8420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company