Healthcare Provider Details

I. General information

NPI: 1598767501
Provider Name (Legal Business Name): KWPH ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 03/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 E TULARE ST
FRESNO CA
93721-1502
US

IV. Provider business mailing address

2911 E TULARE ST
FRESNO CA
93721-1502
US

V. Phone/Fax

Practice location:
  • Phone: 559-443-5991
  • Fax: 559-441-8260
Mailing address:
  • Phone: 559-443-5991
  • Fax: 559-441-8260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateCA

VIII. Authorized Official

Name: MS. DONNA L HANKINS
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 559-443-5991