Provider Demographics
NPI:1609373075
Name:EMELIFE, KEVIN I
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:I
Last Name:EMELIFE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9775 SAGE GROVE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5732
Mailing Address - Country:US
Mailing Address - Phone:312-863-9395
Mailing Address - Fax:702-993-2460
Practice Address - Street 1:9775 SAGE GROVE CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5732
Practice Address - Country:US
Practice Address - Phone:312-863-9395
Practice Address - Fax:702-993-2460
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)