=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831066182
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KEVAK MEDICAL TRANSPORT LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/21/2025
-----------------------------------------------------
Last Update Date | 10/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2252 RAIDER DR
-----------------------------------------------------
City | CONROE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77301-2688
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-841-9325
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2252 RAIDER DR
-----------------------------------------------------
City | CONROE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77301-2688
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-841-9325
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MOTUNRAYO AKINNIRANYE
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 973-841-9325
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343800000X
-----------------------------------------------------
Taxonomy Name | Secured Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------