Provider Demographics
NPI:1801403191
Name:KR HEALTHCARE AND TRANSPORTATION LLC
Entity Type:Organization
Organization Name:KR HEALTHCARE AND TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENSON
Authorized Official - Middle Name:
Authorized Official - Last Name:EGHRERINIOVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-497-9209
Mailing Address - Street 1:2627 W FLORIDA AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-4618
Mailing Address - Country:US
Mailing Address - Phone:951-400-5541
Mailing Address - Fax:
Practice Address - Street 1:2627 W FLORIDA AVE STE 206
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92545-4618
Practice Address - Country:US
Practice Address - Phone:951-400-5541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies