Provider Demographics
NPI:1942933288
Name:KDRJ LOGISTICS, LLC
Entity Type:Organization
Organization Name:KDRJ LOGISTICS, LLC
Other - Org Name:B & B NON-EMERGENCY MEDICAL TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KETRA
Authorized Official - Middle Name:CHAVELL
Authorized Official - Last Name:LOMAX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-458-9598
Mailing Address - Street 1:PO BOX 361
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77305-0361
Mailing Address - Country:US
Mailing Address - Phone:832-458-9598
Mailing Address - Fax:
Practice Address - Street 1:24011 RICHARDS RD APT 702
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-3266
Practice Address - Country:US
Practice Address - Phone:832-458-9598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KDRJ LOGISTICS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-05
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)