Provider Demographics
NPI:1104524131
Name:K-RGV MEDICAL TRANSPORT SERVICE
Entity type:Organization
Organization Name:K-RGV MEDICAL TRANSPORT SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER -MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BERIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SURIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-800-4269
Mailing Address - Street 1:4603 N JACKSON RD STE A-1
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6160
Mailing Address - Country:US
Mailing Address - Phone:551-666-1137
Mailing Address - Fax:
Practice Address - Street 1:4603 N JACKSON RD STE A-1
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6160
Practice Address - Country:US
Practice Address - Phone:956-359-9241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DME MARKET LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-20
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)