Healthcare Provider Details

I. General information

NPI: 1902083710
Provider Name (Legal Business Name): JFK TRANSPORTATION CO., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 04/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 W. 17TH STREET SUITE B
SANTA ANA CA
92706-3554
US

IV. Provider business mailing address

980 W. 17TH STREET SUITE B
SANTA ANA CA
92706-3554
US

V. Phone/Fax

Practice location:
  • Phone: 714-543-4629
  • Fax: 714-543-0306
Mailing address:
  • Phone: 714-543-4629
  • Fax: 714-543-0306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. KEVIN WATSON
Title or Position: DIRECTOR
Credential:
Phone: 714-543-4629