Provider Demographics
NPI:1235884297
Name:K&L TRANSPORT LLC
Entity Type:Organization
Organization Name:K&L TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:HADISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-363-0536
Mailing Address - Street 1:PO BOX 3213
Mailing Address - Street 2:
Mailing Address - City:PINETOP
Mailing Address - State:AZ
Mailing Address - Zip Code:85935-3213
Mailing Address - Country:US
Mailing Address - Phone:928-363-0536
Mailing Address - Fax:
Practice Address - Street 1:674 E WHITE MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:PINETOP
Practice Address - State:AZ
Practice Address - Zip Code:85935-3213
Practice Address - Country:US
Practice Address - Phone:928-363-0536
Practice Address - Fax:928-367-6838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)