Healthcare Provider Details

I. General information

NPI: 1881431518
Provider Name (Legal Business Name): K ALI TRANSPORTATION L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2513 GILLIONVILLE RD APT B
ALBANY GA
31707-6102
US

IV. Provider business mailing address

2513 GILLIONVILLE RD APT B
ALBANY GA
31707-6102
US

V. Phone/Fax

Practice location:
  • Phone: 856-316-5539
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: KAHEED COSGROVE
Title or Position: OWNER
Credential:
Phone: 856-316-5539