Organization
POE'S TRANSIT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP WAYNE POE (OWNER)
(618) 833-2211
Entity
Organization
Contact information
Practice address
40 LAKEVIEW ST, WOLF LAKE, IL 62998-1000
(573) 429-7513
(618) 833-8910
Mailing address
40 LAKEVIEW ST, WOLF LAKE, IL 62998-1000
(573) 429-7513
(618) 833-8910
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
10393PT
IL
343900000X
Non-emergency Medical Transport (VAN)
Primary
10347PT
IL
343900000X
Non-emergency Medical Transport (VAN)
10348PT
IL
Other
Enumeration date
05/01/2009
Last updated
05/01/2009
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