Provider Demographics
NPI:1720140866
Name:LAVELLS TRANSPORT INC
Entity Type:Organization
Organization Name:LAVELLS TRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TORRANCE
Authorized Official - Middle Name:LAVELL
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-464-3686
Mailing Address - Street 1:5767 N 98TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-2507
Mailing Address - Country:US
Mailing Address - Phone:414-464-3686
Mailing Address - Fax:414-464-5332
Practice Address - Street 1:5767 N 98TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53225-2507
Practice Address - Country:US
Practice Address - Phone:414-464-3686
Practice Address - Fax:414-464-5332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI41473200343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41473200OtherPROVIDER NUMBER