Organization
BIZZY KIDZ KAB COMPANY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NIKETA GALLOWAY (OWNER)
(803) 526-7979
Entity
Organization
Contact information
Practice address
2764 PLEASANT RD # 11223, FORT MILL, SC 29708-7299
(803) 526-7979
Mailing address
2764 PLEASANT RD # 11223, FORT MILL, SC 29708-7299
(803) 526-7979
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
PCORS 9039
SC
347C00000X
Private Vehicle
PCORS 9039
SC
Other
Enumeration date
05/31/2016
Last updated
05/31/2016
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