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General NPI Number Information
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NPI Number | 1932061827
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Entity Type | Organization
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Legal Business Name | KMK MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 11/29/2025
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Last Update Date | 11/29/2025
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Provider Practice Location Address
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Address Line | 120 MILL ST APT 201
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City | WOONSOCKET
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State | RI
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Zip | 02895-8203
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Country | US
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Telephone | 401-317-8133
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Fax |
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Provider Business Mailing Address
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Address Line | 120 MILL ST APT 201
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City | WOONSOCKET
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State | RI
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Zip | 02895-8203
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KASSEM KHACHAB
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Credential |
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Telephone | 401-317-9133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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