Organization
KINGDOM CARE TRANSPORTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACI NIKOL FULLER (ADMINISTRATOR)
(804) 501-9456
Entity
Organization
Contact information
Practice address
3621 MILLERS GLEN LN APT 106, HENRICO, VA 23231-2365
(804) 501-9456
Mailing address
3621 MILLERS GLEN LN APT 106, HENRICO, VA 23231-2365
(804) 501-9456
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
10/24/2017
Last updated
10/24/2017
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