Provider Demographics
NPI:1598767501
Name:KWPH ENTERPRISES INC
Entity Type:Organization
Organization Name:KWPH ENTERPRISES INC
Other - Org Name:AMERICAN AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HANKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-443-5991
Mailing Address - Street 1:2911 E TULARE ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1502
Mailing Address - Country:US
Mailing Address - Phone:559-443-5991
Mailing Address - Fax:559-441-8260
Practice Address - Street 1:2911 E TULARE ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1502
Practice Address - Country:US
Practice Address - Phone:559-443-5991
Practice Address - Fax:559-441-8260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ75078ZMedicaid
CAZZZ75078ZMedicaid