Provider Demographics
NPI:1992085559
Name:COLEMAN'S CARE CAB
Entity type:Organization
Organization Name:COLEMAN'S CARE CAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-949-5070
Mailing Address - Street 1:4626 WEST DEER RUN DR
Mailing Address - Street 2:APT 201
Mailing Address - City:BROWN DEER
Mailing Address - State:WI
Mailing Address - Zip Code:53223
Mailing Address - Country:US
Mailing Address - Phone:414-949-5070
Mailing Address - Fax:
Practice Address - Street 1:4626 W DEER RUN DR
Practice Address - Street 2:APT 201
Practice Address - City:BROWN DEER
Practice Address - State:WI
Practice Address - Zip Code:53223-6448
Practice Address - Country:US
Practice Address - Phone:414-949-5070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-26
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI343900000X
WIW4165317964702343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)