MEDICARE: KENBAR ENTERPRIZES INC

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1104347798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENBAR ENTERPRIZES INC

Provider Business Mailing Address
First Line	:	1111 CHURCH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-2803
Country	:	US
Telephone Number	:	347-533-6221
Fax Number	:	347-534-1411

Provider Business Practice Location Address
First Line	:	1111 CHURCH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-2803
Country	:	US
Telephone Number	:	917-500-4572
Fax Number	:	347-534-1411

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MRS. BAARBARA STEWART
Credential	:
Telephone Number	:	347-533-6221

Provider Enumeration Date	:	07/05/2017
Last Update Date	:	07/05/2017

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