Organization
DISTINCTIVE CARE TRANSPORTATION COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNY E SAMUEL (PARTNER)
(414) 406-1438
Entity
Organization
Contact information
Practice address
6621 N YUBA ST, MILWAUKEE, WI 53223-5759
(414) 406-1438
(414) 353-5633
Mailing address
PO BOX 090374, MILWAUKEE, WI 53209-0374
(414) 406-1438
(414) 353-5633
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
41488300
WI
Other
Enumeration date
12/31/2007
Last updated
12/31/2007
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