Provider Demographics
NPI:1558123612
Name:KO ENTERPRISE GROUP
Entity Type:Organization
Organization Name:KO ENTERPRISE GROUP
Other - Org Name:KO TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-809-9955
Mailing Address - Street 1:7830 HIGHWAY 72 W # 1052
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-9500
Mailing Address - Country:US
Mailing Address - Phone:256-542-1071
Mailing Address - Fax:
Practice Address - Street 1:7830 HIGHWAY 72 W # 1052
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9500
Practice Address - Country:US
Practice Address - Phone:256-542-1071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)