Provider Demographics
NPI:1700264041
Name:INCARE KONGA TRANSPORTATION CORPORATION
Entity Type:Organization
Organization Name:INCARE KONGA TRANSPORTATION CORPORATION
Other - Org Name:INCAREKONGA TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SALOME
Authorized Official - Middle Name:D
Authorized Official - Last Name:SAMEJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-779-8838
Mailing Address - Street 1:5161 VERDE VALLEY LN # 2201
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254
Mailing Address - Country:US
Mailing Address - Phone:214-779-8838
Mailing Address - Fax:
Practice Address - Street 1:5161 VERDE VALLEY LN APT 2201
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7424
Practice Address - Country:US
Practice Address - Phone:214-779-8838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)