Organization
MIDSTATE MEDICAL EXPRESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA L WATSON (PARTNER/OFFICE MANAGER)
(608) 742-8603
Entity
Organization
Contact information
Practice address
512 W PLEASANT ST, PORTAGE, WI 53901-2012
(608) 742-8603
(608) 745-0640
Mailing address
PO BOX 303, 512 W PLEASANT ST, PORTAGE, WI 53901-0303
(608) 742-8603
(608) 745-0640
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41453400
—
WI
Enumeration date
02/09/2009
Last updated
02/09/2009
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