Provider Demographics
NPI:1710044540
Name:KWICK TRANSPORT, INC.
Entity Type:Organization
Organization Name:KWICK TRANSPORT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KITTY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-341-4229
Mailing Address - Street 1:1120 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-1250
Mailing Address - Country:US
Mailing Address - Phone:423-341-4229
Mailing Address - Fax:423-245-4654
Practice Address - Street 1:1120 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-1250
Practice Address - Country:US
Practice Address - Phone:423-341-4229
Practice Address - Fax:423-245-4654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNT000159Medicaid