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General NPI Number Information
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NPI Number | 1457995003
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Entity Type | Organization
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Legal Business Name | KINGSWAY MEDICAL TRANSPORT LLC
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Dates
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Enumeration Date | 11/06/2019
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Last Update Date | 11/06/2019
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Provider Practice Location Address
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Address Line | 938 W MAIN ST STE 1
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City | HILLSBORO
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State | OH
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Zip | 45133-7656
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Country | US
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Telephone | 937-402-4070
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Fax | 614-890-7374
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Provider Business Mailing Address
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Address Line | 9970 E PROSPECT RD
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City | HILLSBORO
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State | OH
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Zip | 45133-8910
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Country | US
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Telephone | 937-763-9983
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Fax | 614-890-7374
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Authorized Official
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Title or Position | OWNER
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Name | MR. RAY LANHAM
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Credential |
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Telephone | 937-763-9983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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