Provider Demographics
NPI:1073381489
Name:KASK NON-EMERGENCY TRANSPORTATION
Entity Type:Organization
Organization Name:KASK NON-EMERGENCY TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DRIVER
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-589-3698
Mailing Address - Street 1:2312 GLENEAGLES DR APT A
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-5099
Mailing Address - Country:US
Mailing Address - Phone:229-589-3698
Mailing Address - Fax:
Practice Address - Street 1:2312 GLENEAGLES DR APT A
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-5099
Practice Address - Country:US
Practice Address - Phone:229-589-3698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle