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General NPI Number Information
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NPI Number | 1093591596
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Entity Type | Organization
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Legal Business Name | INTERKON GUIDED SERVICES LLC
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Dates
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Enumeration Date | 08/31/2023
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 1800 GLOUCESTER DR
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City | BAKERSFIELD
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State | CA
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Zip | 93311-9245
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Country | US
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Telephone | 310-210-4359
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Fax |
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Provider Business Mailing Address
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Address Line | 136 ALLEN RD STE 100-1024
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City | BAKERSFIELD
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State | CA
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Zip | 93314-3710
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Country | US
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Telephone | 310-210-4359
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. KHALED SHAKTA
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Credential |
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Telephone | 310-210-4359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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