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Organization

EKALLEVIG TRANSPORT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KENNETH E KALLEVIG (OWNER)
(321) 514-0075
Entity
Organization

Contact information

Practice address
20 LAKEVIEW CT, PALM HARBOR, FL 34683-2906
(321) 514-0075
Mailing address
20 LAKEVIEW CT, PALM HARBOR, FL 34683-2906
(321) 514-0075

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
11017
FL
343900000X
Non-emergency Medical Transport (VAN)
Primary
11017
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
341600000
PRIVATE
FL
01
343900000
PRIVATE
FL
Enumeration date
03/10/2016
Last updated
03/10/2016
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