Provider Demographics
NPI:1750069993
Name:TRAVEL WISE MOBILE
Entity type:Organization
Organization Name:TRAVEL WISE MOBILE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:248-864-5151
Mailing Address - Street 1:24681 NORTHWESTERN HWY STE 2018
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2321
Mailing Address - Country:US
Mailing Address - Phone:248-864-5151
Mailing Address - Fax:248-852-6803
Practice Address - Street 1:24681 NORTHWESTERN HWY STE 2018
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2321
Practice Address - Country:US
Practice Address - Phone:248-864-5151
Practice Address - Fax:248-852-6803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)