MEDICARE: KIMWAY TRANSPORTATION SERVICES 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	:	1902267826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIMWAY TRANSPORTATION SERVICES INC

Provider Business Mailing Address
First Line	:	2500 OAK GROVE RD
Second Line	:
City	:	GASBURG
State	:	VA
Zip	:	23857-2324
Country	:	US
Telephone Number	:	804-586-1495
Fax Number	:	434-577-2360

Provider Business Practice Location Address
First Line	:	2500 OAK GROVE RD
Second Line	:
City	:	GASBURG
State	:	VA
Zip	:	23857-2324
Country	:	US
Telephone Number	:	804-586-1495
Fax Number	:	434-577-2360

Authorized Official
Title or Position	:	OWNER
Name	:	KIMBERLY TURNER
Credential	:
Telephone Number	:	804-586-1495

Provider Enumeration Date	:	03/20/2016
Last Update Date	:	03/20/2016

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