Provider Demographics
NPI:1891426482
Name:KENNEDYS TRANSPORTATION LLC
Entity Type:Organization
Organization Name:KENNEDYS TRANSPORTATION LLC
Other - Org Name:NONE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ENOS
Authorized Official - Middle Name:MULBAH
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-201-5842
Mailing Address - Street 1:3442 N BELT LINE RD APT 1074
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-7807
Mailing Address - Country:US
Mailing Address - Phone:972-201-5842
Mailing Address - Fax:
Practice Address - Street 1:3442 N BELT LINE RD APT 1074
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-7807
Practice Address - Country:US
Practice Address - Phone:972-201-5842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1841920972OtherNPI NUMBER
TX1841920972Medicaid