Provider Demographics
NPI:1740768704
Name:TAMBA-KROMAH VENTURES LLC
Entity Type:Organization
Organization Name:TAMBA-KROMAH VENTURES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FESTUS
Authorized Official - Middle Name:
Authorized Official - Last Name:KROMAH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:781-484-7776
Mailing Address - Street 1:29 DUNGEON AVE
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01905
Mailing Address - Country:US
Mailing Address - Phone:781-691-0441
Mailing Address - Fax:
Practice Address - Street 1:29 DUNGEON AVE
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01905
Practice Address - Country:US
Practice Address - Phone:781-691-0441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-01
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)