Provider Demographics
NPI:1871910281
Name:LTB TRANSPORTATION INC.
Entity type:Organization
Organization Name:LTB TRANSPORTATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DRIVER
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-795-9731
Mailing Address - Street 1:1915 W FAIRMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-5722
Mailing Address - Country:US
Mailing Address - Phone:414-795-9731
Mailing Address - Fax:
Practice Address - Street 1:1915 W FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-5722
Practice Address - Country:US
Practice Address - Phone:414-795-9731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-24
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)