Provider Demographics
NPI:1174974539
Name:K&L MEDICAL TRANSPORTATION, LLC
Entity type:Organization
Organization Name:K&L MEDICAL TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-589-2234
Mailing Address - Street 1:PO BOX 411
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:NY
Mailing Address - Zip Code:14589-0411
Mailing Address - Country:US
Mailing Address - Phone:315-589-2234
Mailing Address - Fax:
Practice Address - Street 1:3629 SUNSET LN
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:NY
Practice Address - Zip Code:14589-9223
Practice Address - Country:US
Practice Address - Phone:585-301-3827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1033318407Medicaid