Provider Demographics
NPI:1205353257
Name:3 KINGS TRANSPORTATION
Entity type:Organization
Organization Name:3 KINGS TRANSPORTATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SMALLWOOD
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:330-647-3137
Mailing Address - Street 1:6128 SAINT ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9023
Mailing Address - Country:US
Mailing Address - Phone:330-647-3137
Mailing Address - Fax:800-304-3604
Practice Address - Street 1:202 N MERIDIAN RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44509-1858
Practice Address - Country:US
Practice Address - Phone:234-855-0193
Practice Address - Fax:800-304-3604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0050789Medicaid