Provider Demographics
NPI:1083142160
Name:KINGS MEDICAL TRANSPORTATION INCORPORTED
Entity Type:Organization
Organization Name:KINGS MEDICAL TRANSPORTATION INCORPORTED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ONYEDIKACHI
Authorized Official - Middle Name:EVANS
Authorized Official - Last Name:UGORJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-252-8521
Mailing Address - Street 1:1727 KING ST STE 300
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2761
Mailing Address - Country:US
Mailing Address - Phone:703-203-5295
Mailing Address - Fax:
Practice Address - Street 1:1727 KING STRREET
Practice Address - Street 2:SUITE 300
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314
Practice Address - Country:US
Practice Address - Phone:703-203-5295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-01
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA555343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========OtherNON EMERGENCY MEDICAL TRANSPORTATION