Provider Demographics
NPI:1689358293
Name:IKET CORPORATION
Entity Type:Organization
Organization Name:IKET CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TEKESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LORICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-649-5918
Mailing Address - Street 1:1566 MARLWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-4023
Mailing Address - Country:US
Mailing Address - Phone:704-649-5918
Mailing Address - Fax:
Practice Address - Street 1:1566 MARLWOOD CIR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-4023
Practice Address - Country:US
Practice Address - Phone:704-649-5918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)