Provider Demographics
NPI:1245718394
Name:KMT MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:KMT MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:EVANS
Authorized Official - Middle Name:O
Authorized Official - Last Name:UGORJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-775-6868
Mailing Address - Street 1:1727 KING ST STE 300
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2761
Mailing Address - Country:US
Mailing Address - Phone:833-775-6868
Mailing Address - Fax:833-552-7009
Practice Address - Street 1:1727 KING ST STE 300
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314
Practice Address - Country:US
Practice Address - Phone:877-215-3772
Practice Address - Fax:703-635-7507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Single Specialty