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General NPI Number Information
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NPI Number | 1124514963
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Entity Type | Organization
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Legal Business Name | TRU-KING TRANSPORTATION
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Dates
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Enumeration Date | 07/05/2018
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Last Update Date | 07/05/2018
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Provider Practice Location Address
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Address Line | 104 ANDREW ST
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City | SHANNON
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State | MS
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Zip | 38868
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Country | US
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Telephone | 662-816-1921
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Fax |
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Provider Business Mailing Address
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Address Line | 104 ANDREW ST
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City | SHANNON
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State | MS
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Zip | 38868-9417
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Country | US
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Telephone | 662-816-1921
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KIMBERLY R BEATY
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Credential |
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Telephone | 662-816-1921
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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 | 801627644
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License Number State | MS
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