Provider Demographics
NPI:1508492273
Name:AK LOGISTICARE LLC
Entity Type:Organization
Organization Name:AK LOGISTICARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ASMEROM
Authorized Official - Middle Name:K
Authorized Official - Last Name:GEBRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-892-0589
Mailing Address - Street 1:12533 BURNINGLOG LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3229
Mailing Address - Country:US
Mailing Address - Phone:214-892-0586
Mailing Address - Fax:
Practice Address - Street 1:9304 FOREST LN STE S242
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6238
Practice Address - Country:US
Practice Address - Phone:214-892-0586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)