MEDICARE: KMJ TRANSIT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	342000000X	Transportation Network Company

General Provider Information

NPI Number	:	1083448526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KMJ TRANSIT LLC

Provider Business Mailing Address
First Line	:	1028 N MISSOURI ST STE 4
Second Line	:
City	:	WEST MEMPHIS
State	:	AR
Zip	:	72301-2600
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1028 N MISSOURI ST STE 4
Second Line	:
City	:	WEST MEMPHIS
State	:	AR
Zip	:	72301-2600
Country	:	US
Telephone Number	:	870-771-0813
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JERICA SMITH
Credential	:
Telephone Number	:	901-462-1619

Provider Enumeration Date	:	08/28/2024
Last Update Date	:	09/03/2024

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Directions to “KMJ TRANSIT LLC ” Practice Location

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