Provider Demographics
NPI:1104113737
Name:KINGDOM CONNECTIONS, INC.
Entity type:Organization
Organization Name:KINGDOM CONNECTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:BRUNSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:704-906-7388
Mailing Address - Street 1:PO BOX 561865
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28256-1865
Mailing Address - Country:US
Mailing Address - Phone:704-906-7388
Mailing Address - Fax:
Practice Address - Street 1:462 PIER POINT CT NW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-2541
Practice Address - Country:US
Practice Address - Phone:704-906-7388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-04
Last Update Date:2011-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347B00000XTransportation ServicesBus
No347C00000XTransportation ServicesPrivate Vehicle