Provider Demographics
NPI:1629477906
Name:K P L J TRANSPORTATION SERVICES
Entity Type:Organization
Organization Name:K P L J TRANSPORTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:K
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-338-4120
Mailing Address - Street 1:PO BOX 167
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44309-0167
Mailing Address - Country:US
Mailing Address - Phone:234-678-6579
Mailing Address - Fax:234-678-6669
Practice Address - Street 1:1142 LOCKWOOD RD
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-4571
Practice Address - Country:US
Practice Address - Phone:234-678-6579
Practice Address - Fax:234-678-6669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2539006Medicaid
OH2727106Medicaid