Provider Demographics
NPI:1952723793
Name:GWB TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:GWB TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:248-460-6454
Mailing Address - Street 1:25514 W 12 MILE RD
Mailing Address - Street 2:STE. 303
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034
Mailing Address - Country:US
Mailing Address - Phone:248-460-6454
Mailing Address - Fax:888-386-2013
Practice Address - Street 1:25514 W 12 MILE RD
Practice Address - Street 2:STE. 303
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034
Practice Address - Country:US
Practice Address - Phone:248-460-6454
Practice Address - Fax:888-386-2013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
No341600000XTransportation ServicesAmbulance
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi