Healthcare Provider Details

I. General information

NPI: 1255247656
Provider Name (Legal Business Name): LARK MEDICAL TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 E 3RD ST
ELK RAPIDS MI
49629-9402
US

IV. Provider business mailing address

722 E 3RD ST
ELK RAPIDS MI
49629-9402
US

V. Phone/Fax

Practice location:
  • Phone: 910-489-4729
  • Fax:
Mailing address:
  • Phone: 910-489-4729
  • Fax:

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. BRIAN KELLY LARK II
Title or Position: OWNER
Credential: EMT-B, LPN
Phone: 910-489-4729