Provider Demographics
NPI:1528567096
Name:KOTA TRANSPORT SERVICE LLC
Entity Type:Organization
Organization Name:KOTA TRANSPORT SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:BATTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-883-1693
Mailing Address - Street 1:301 N MORING AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27801-6246
Mailing Address - Country:US
Mailing Address - Phone:252-883-1693
Mailing Address - Fax:252-231-0324
Practice Address - Street 1:301 N MORING AVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27801-6246
Practice Address - Country:US
Practice Address - Phone:252-883-1693
Practice Address - Fax:252-231-0324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-09
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)