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General NPI Number Information
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NPI Number | 1194186809
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Entity Type | Organization
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Legal Business Name | KRK TRANSPORTATION GROUP LLC
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Dates
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Enumeration Date | 03/09/2016
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Last Update Date | 03/09/2016
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Provider Practice Location Address
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Address Line | 2200 CASTOR AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19134-2703
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Country | US
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Telephone | 267-602-7715
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Fax |
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Provider Business Mailing Address
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Address Line | 1828 BAINBRIDGE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19146-1807
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Country | US
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Telephone | 267-602-7715
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. MITCHELL RICARDO EPPS
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Credential |
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Telephone | 267-602-7715
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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 | 343900000X
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License Number State | PA
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