Provider Demographics
NPI:1982146940
Name:KDMEDLINK SERVICES, LLC
Entity Type:Organization
Organization Name:KDMEDLINK SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TANY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGOCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-872-0665
Mailing Address - Street 1:426 WINDY KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-5338
Mailing Address - Country:US
Mailing Address - Phone:972-384-3500
Mailing Address - Fax:
Practice Address - Street 1:426 WINDY KNOLL DR
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-5338
Practice Address - Country:US
Practice Address - Phone:972-384-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)