Provider Demographics
NPI:1366199390
Name:KSAM INSPIRATION LLC
Entity type:Organization
Organization Name:KSAM INSPIRATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MBEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-261-0736
Mailing Address - Street 1:3308 BILL OWENS PKWY
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-1612
Mailing Address - Country:US
Mailing Address - Phone:903-261-0736
Mailing Address - Fax:
Practice Address - Street 1:3308 BILL OWENS PKWY
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-1612
Practice Address - Country:US
Practice Address - Phone:903-261-0736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)