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General NPI Number Information
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NPI Number | 1366262610
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Entity Type | Organization
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Legal Business Name | KMB PREMIER ENTERPRISES LLC
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 4814 ALAINA DR
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City | ROSHARON
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State | TX
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Zip | 77583-0349
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Country | US
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Telephone | 470-443-7230
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Fax | 213-449-4107
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Provider Business Mailing Address
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Address Line | 4814 ALAINA DR
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City | ROSHARON
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State | TX
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Zip | 77583-0349
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Country | US
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Telephone | 470-443-7230
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Fax | 213-449-4107
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Authorized Official
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Title or Position | OWNER
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Name | MS. KIMBERLY CONLEY
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Credential |
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Telephone | 470-443-7230
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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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