Provider Demographics
NPI:1740952480
Name:KIWI EMERGENCY MEDICAL SERVICES
Entity type:Organization
Organization Name:KIWI EMERGENCY MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MARKETING
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:M
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:JR
Authorized Official - Credentials:EMT- ADVANCED
Authorized Official - Phone:540-784-9582
Mailing Address - Street 1:N 2930 STATE ROAD 22
Mailing Address - Street 2:
Mailing Address - City:WAUPOMA
Mailing Address - State:WI
Mailing Address - Zip Code:24982
Mailing Address - Country:US
Mailing Address - Phone:800-786-4911
Mailing Address - Fax:855-738-0968
Practice Address - Street 1:35 MAGNOLIA SQ STE 10
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-3779
Practice Address - Country:US
Practice Address - Phone:540-784-9582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-30
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
9999999999OtherNONE