Provider Demographics
NPI:1275964595
Name:ALICE & KAYES MEDICAL
Entity Type:Organization
Organization Name:ALICE & KAYES MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-623-5415
Mailing Address - Street 1:PO BOX 631
Mailing Address - Street 2:
Mailing Address - City:LECOMPTE
Mailing Address - State:LA
Mailing Address - Zip Code:71346-0631
Mailing Address - Country:US
Mailing Address - Phone:318-776-9698
Mailing Address - Fax:318-776-0598
Practice Address - Street 1:1410 FORD ST.
Practice Address - Street 2:
Practice Address - City:LECOMPTE
Practice Address - State:LA
Practice Address - Zip Code:71346
Practice Address - Country:US
Practice Address - Phone:318-776-9896
Practice Address - Fax:318-776-0598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-12
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA006319365343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)