Provider Demographics
NPI:1194615708
Name:KINGDOM CARE TRANSPORTATION
Entity type:Organization
Organization Name:KINGDOM CARE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARTIER
Authorized Official - Middle Name:MARTISE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-786-2385
Mailing Address - Street 1:PO BOX 7663
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92552-7663
Mailing Address - Country:US
Mailing Address - Phone:323-786-2385
Mailing Address - Fax:
Practice Address - Street 1:13080 EDGEMONT ST APT 103
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-8076
Practice Address - Country:US
Practice Address - Phone:909-745-2363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)