Provider Demographics
NPI:1063996296
Name:MK1 TRANSPORTATION LLC
Entity type:Organization
Organization Name:MK1 TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KURZULIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-422-7929
Mailing Address - Street 1:3201 N GLENOAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-2009
Mailing Address - Country:US
Mailing Address - Phone:818-848-3293
Mailing Address - Fax:818-848-9943
Practice Address - Street 1:3201 N GLENOAKS BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-2009
Practice Address - Country:US
Practice Address - Phone:818-848-3293
Practice Address - Fax:818-848-9943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)