Provider Demographics
NPI:1417632464
Name:K B K LLC TRANSPORT
Entity type:Organization
Organization Name:K B K LLC TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSPORTATION
Authorized Official - Prefix:MR
Authorized Official - First Name:IBRAHIM
Authorized Official - Middle Name:MOHAMUD
Authorized Official - Last Name:IBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:IBRAHIM
Authorized Official - Phone:716-431-0218
Mailing Address - Street 1:725 W LAPHAM BLVD APT 11
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53204-3446
Mailing Address - Country:US
Mailing Address - Phone:716-431-0218
Mailing Address - Fax:
Practice Address - Street 1:725 W LAPHAM BLVD APT 11
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53204-3446
Practice Address - Country:US
Practice Address - Phone:716-431-0218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WV0202XOther Service ProvidersContractorVehicle ModificationsGroup - Multi-Specialty