Provider Demographics
NPI:1447018239
Name:KINGDOM TRAVEL TRANSPORTATION LLC
Entity type:Organization
Organization Name:KINGDOM TRAVEL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:EVETTE
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-339-4530
Mailing Address - Street 1:701 MAGRUDER LNDG
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-4061
Mailing Address - Country:US
Mailing Address - Phone:706-339-4530
Mailing Address - Fax:706-739-4637
Practice Address - Street 1:701 MAGRUDER LNDG
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-4061
Practice Address - Country:US
Practice Address - Phone:706-339-4530
Practice Address - Fax:706-739-4637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)