Provider Demographics
NPI:1568140572
Name:KROL NINE LLC
Entity Type:Organization
Organization Name:KROL NINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:LEILANI
Authorized Official - Last Name:BOYNTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-420-2692
Mailing Address - Street 1:4035 JONESBORO RD STE 240
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30297-1090
Mailing Address - Country:US
Mailing Address - Phone:470-420-2692
Mailing Address - Fax:
Practice Address - Street 1:4035 JONESBORO RD STE 240
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-1090
Practice Address - Country:US
Practice Address - Phone:470-420-2692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)