Provider Demographics
NPI:1508327768
Name:KCB TRANSPORT LLC
Entity Type:Organization
Organization Name:KCB TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WINDY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TROXEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-951-3295
Mailing Address - Street 1:14405 TABLE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:CENTRAL POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97502-9377
Mailing Address - Country:US
Mailing Address - Phone:541-951-3295
Mailing Address - Fax:
Practice Address - Street 1:14405 TABLE ROCK RD
Practice Address - Street 2:
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-9377
Practice Address - Country:US
Practice Address - Phone:541-951-3295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi