Provider Demographics
NPI:1740853159
Name:EPIC EXPRESS MEDICAL TRANSPORT INC
Entity type:Organization
Organization Name:EPIC EXPRESS MEDICAL TRANSPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FELISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-822-6287
Mailing Address - Street 1:11011 W NORTH AVE APT 137
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-2299
Mailing Address - Country:US
Mailing Address - Phone:262-822-6287
Mailing Address - Fax:414-988-6173
Practice Address - Street 1:11011 W NORTH AVE APT 137
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-2299
Practice Address - Country:US
Practice Address - Phone:262-822-6287
Practice Address - Fax:414-988-6173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date: