Provider Demographics
NPI:1245796143
Name:KEYES TRANSPORT SERVICE LLC
Entity Type:Organization
Organization Name:KEYES TRANSPORT SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERMAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-620-6901
Mailing Address - Street 1:817 SCR 103
Mailing Address - Street 2:
Mailing Address - City:LOUIN
Mailing Address - State:MS
Mailing Address - Zip Code:39338-4970
Mailing Address - Country:US
Mailing Address - Phone:601-620-6901
Mailing Address - Fax:
Practice Address - Street 1:817 SCR 103
Practice Address - Street 2:
Practice Address - City:LOUIN
Practice Address - State:MS
Practice Address - Zip Code:39338-4970
Practice Address - Country:US
Practice Address - Phone:601-620-6901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)