Healthcare Provider Details

I. General information

NPI: 1649194556
Provider Name (Legal Business Name): MK&F MEDICAL TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 CHANDA CV
MCDONOUGH GA
30253-8523
US

IV. Provider business mailing address

3419 VIRGINIA BEACH BLVD # 5164
VIRGINIA BEACH VA
23452-4419
US

V. Phone/Fax

Practice location:
  • Phone: 757-609-5208
  • Fax:
Mailing address:
  • Phone: 757-609-5208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY GILLIAM
Title or Position: MANAGER
Credential: PROVIDER
Phone: 470-710-7902