MEDICARE: S AND K TRANSPORT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	919448	VA

General Provider Information

NPI Number	:	1043764590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S AND K TRANSPORT

Provider Business Mailing Address
First Line	:	2224 MARSHALL AVE
Second Line	:	APT A
City	:	NORFOLK
State	:	VA
Zip	:	23504-2636
Country	:	US
Telephone Number	:	757-952-8755
Fax Number	:	757-822-6162

Provider Business Practice Location Address
First Line	:	2224 MARSHALL AVE
Second Line	:	APT A
City	:	NORFOLK
State	:	VA
Zip	:	23504-2636
Country	:	US
Telephone Number	:	757-952-8755
Fax Number	:	757-822-6162

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. KIMBERLY DENISE RICHARDSON
Credential	:
Telephone Number	:	757-952-8755

Provider Enumeration Date	:	08/12/2016
Last Update Date	:	08/12/2016

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Directions to “S AND K TRANSPORT ” Practice Location

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