Provider Demographics
NPI:1225331499
Name:K & A SERVICES, CORP
Entity Type:Organization
Organization Name:K & A SERVICES, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTHIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-551-6770
Mailing Address - Street 1:9266 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-2208
Mailing Address - Country:US
Mailing Address - Phone:904-551-6770
Mailing Address - Fax:904-619-2688
Practice Address - Street 1:9266 ADAMS AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-2208
Practice Address - Country:US
Practice Address - Phone:904-551-6770
Practice Address - Fax:904-619-2688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-10
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002557200OtherMEDICAID PROVIDER NUMBER