Provider Demographics
NPI:1942050091
Name:COVENANT TRANSPORT
Entity type:Organization
Organization Name:COVENANT TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:KAMAU KARIUKI
Authorized Official - Last Name:KYANDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-400-1230
Mailing Address - Street 1:1206 SE RIO DR
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-3848
Mailing Address - Country:US
Mailing Address - Phone:515-400-1230
Mailing Address - Fax:
Practice Address - Street 1:1206 SE RIO DR
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-3848
Practice Address - Country:US
Practice Address - Phone:515-400-1230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)