Provider Demographics
NPI: | 1831410737 |
---|---|
Name: | K.LASTER TRANPORTATION |
Entity type: | Organization |
Organization Name: | K.LASTER TRANPORTATION |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | SOLE PROPRIATER |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | KATHERINE |
Authorized Official - Middle Name: | JEAN |
Authorized Official - Last Name: | LASTER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 916-290-3117 |
Mailing Address - Street 1: | 8634 CORD WAY |
Mailing Address - Street 2: | |
Mailing Address - City: | SACRAMENTO |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 95828-5805 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 916-290-3117 |
Mailing Address - Fax: | 916-689-5992 |
Practice Address - Street 1: | 8634 CORD WAY |
Practice Address - Street 2: | |
Practice Address - City: | SACRAMENTO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 95828-5805 |
Practice Address - Country: | US |
Practice Address - Phone: | 916-290-3117 |
Practice Address - Fax: | 916-689-5992 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-06-15 |
Last Update Date: | 2010-06-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | 346660 | 343900000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) |