Provider Demographics
NPI:1679118640
Name:B&K TRANSPORTATION LLC
Entity Type:Organization
Organization Name:B&K TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BETHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:IMAIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-207-3208
Mailing Address - Street 1:3120 BATTLEMENT CIR
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-8258
Mailing Address - Country:US
Mailing Address - Phone:470-274-1584
Mailing Address - Fax:404-891-3305
Practice Address - Street 1:3120 BATTLEMENT CIR
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-8258
Practice Address - Country:US
Practice Address - Phone:404-207-3208
Practice Address - Fax:404-891-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)