Provider Demographics
NPI:1104369206
Name:K&P MEDICAL TRANSPORT LTD.
Entity type:Organization
Organization Name:K&P MEDICAL TRANSPORT LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-785-3246
Mailing Address - Street 1:25288 ELLIOTT RD
Mailing Address - Street 2:
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-9003
Mailing Address - Country:US
Mailing Address - Phone:419-785-3246
Mailing Address - Fax:419-782-6478
Practice Address - Street 1:25288 ELLIOTT RD
Practice Address - Street 2:
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-9003
Practice Address - Country:US
Practice Address - Phone:419-785-3246
Practice Address - Fax:419-782-6478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0385682Medicaid