ICWM, LLC (NPI# 1457558520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457558520 |
| Entity Type | Organization |
| Organization Name | ICWM, LLC |
| Other Organization Name | WCI TRANSPORTATION SERVICE |
| Practice Address |
59742 Wren Ln South Bend IN 46614-4007 |
| Mailing Address |
Po Box 10037 South Bend IN 46680-0037 |
| Practice Telephone | 5742311998 |
| Practice Fax Number | 5742311997 |
| Mailing Telephone | 5742877068 |
| Mailing Fax Number | 5742877096 |
| Enumeration Date | 2007-06-30 |
| Last Update Date | 2008-02-21 |
| Authorized Official Name | MR. WALTER WILLARD BALLARD III (PRESIDENT) |
| Authorized Official Telephone | 5743831751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 343900000X | Non-emergency Medical Transport (VAN) | USDOT 1427478 IN | IN | Transportation Services |
| Other Name | Type Code |
|---|---|
| WCI Transportation Service | Doing Business As Name - Organization |
| Street Address |
59742 WREN LN |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46614-4007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417574013 | Hellen Gathesha | Nurse Practitioner | 2123 W Irvington Dr, South Bend, IN 46614 | 2020-06-30 |
| 1033759394 | Diane Galvas | Pharmacist | 1217 E. Ireland Rd., South Bend, IN 46614 | 2020-01-14 |
| 1730668690 | Julenne Henriquez-gil | Physical Therapist | 202 W Ireland Rd Ste 101a, South Bend, IN 46614 | 2018-08-11 |
| 1467747014 | Deidre A Coffey | Nurse Practitioner | 1025 Widener Ln, South Bend, IN 46614 | 2011-06-12 |
| 1588727655 | Wal-mart Stores East, Lp | Technician/Technologist | 700 W. Ireland Rd., South Bend, IN 46614 | 2006-12-19 |
| 1437262847 | Lori F Risser | Dentist | 734 E Ireland Rd, South Bend, IN 46614 | 2006-08-17 |
| 1912388018 | Laura Ellen Albright | Family Medicine | 2102 E Inwood Rd, South Bend, IN 46614 | 2015-06-15 |
| 1245626225 | Kathleen Kelley | Dermatology | 1815 E Ireland Rd, South Bend, IN 46614 | 2015-04-07 |
| 1073869806 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1950 Ridgedale Rd, South Bend, IN 46614 | 2012-07-30 |
| 1326300666 | Kristine Marie Jones | Optometrist | 700 W Ireland Rd, South Bend, IN 46614 | 2012-06-12 |
| Find all providers in zip 46614 | ||||
| Taxonomy Code | 343900000X |
| Grouping | Transportation Services |
| Classification | Non-emergency Medical Transport (VAN) |
| A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881218469 | Tasha Marie Tyce | Non-emergency Medical Transport (VAN) | 1218 N Adams St, South Bend, IN 46628-3021 | 2020-05-30 |
| 1659994572 | Andrew Mwangi | Non-emergency Medical Transport (VAN) | 3619 Langley Dr, South Bend, IN 46614-1913 | 2020-05-27 |
| 1285145854 | Chariot Medical Mobile, LLC | Non-emergency Medical Transport (VAN) | 53211 Kinglet Ln, South Bend, IN 46637-5112 | 2017-10-23 |
| 1013306836 | Team Mls Transportation | Non-emergency Medical Transport (VAN) | 1821 East Washington Street, South Bend, IN 46617-3453 | 2015-01-16 |
| 1346594421 | Allan Ross, Inc. | Non-emergency Medical Transport (VAN) | 201 N Olive St, South Bend, IN 46628-2072 | 2012-10-29 |
| 1780932012 | Ali Transportation LLC | Non-emergency Medical Transport (VAN) | 1604 Byron Dr, South Bend, IN 46614-2855 | 2012-08-16 |
| 1831468974 | Bcuz We Care Transportation | Non-emergency Medical Transport (VAN) | 1036 Laurel Ct, South Bend, IN 46601-2701 | 2011-12-19 |
| 1740510924 | St. Joseph Co. Airport Authority | Non-emergency Medical Transport (VAN) | 4821 Lincoln Way W, South Bend, IN 46628-5525 | 2010-01-11 |
| 1295064954 | Southwest Central Fire Territory | Non-emergency Medical Transport (VAN) | 23626 Fillmore Rd, South Bend, IN 46619-1502 | 2009-12-09 |
| 1346401957 | Shauntae Marie Dixon | Non-emergency Medical Transport (VAN) | 23191 Lawrence St, 23191 Lawrence St, South Bend, IN 46628-5250 | 2008-06-17 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46614 |
Please comment or provide details below to improve the information on ICWM, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.