MEDICARE: THREE K'S CARE TRANSPORTATION,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	343800000X	Secured Medical Transport (VAN)	S450711786890	FL
2	343900000X	Non-emergency Medical Transport (VAN)	S450711786890	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942452362
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THREE K'S CARE TRANSPORTATION,INC

Provider Business Mailing Address
First Line	:	7600 BASS LAKE RD
Second Line	:	SUITE 101
City	:	NEW HOPE
State	:	MN
Zip	:	55428-3860
Country	:	US
Telephone Number	:	763-544-3148
Fax Number	:	763-544-3149

Provider Business Practice Location Address
First Line	:	7600 BASS LAKE RD
Second Line	:	SUITE 101
City	:	NEW HOPE
State	:	MN
Zip	:	55428-3860
Country	:	US
Telephone Number	:	763-544-3148
Fax Number	:	763-544-3149

Authorized Official
Title or Position	:	L.P.N./C.E.O
Name	:	MS. QUEENA KOTU SLOAN
Credential	:	L.P.N.
Telephone Number	:	763-544-3148

Provider Enumeration Date	:	10/16/2008
Last Update Date	:	10/16/2008

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Directions to “THREE K'S CARE TRANSPORTATION,INC ” Practice Location

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