Provider Demographics
NPI:1902687130
Name:MCKINNIE CAREMOBILE LLC
Entity Type:Organization
Organization Name:MCKINNIE CAREMOBILE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:QUINTARIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINNIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-652-5702
Mailing Address - Street 1:325 N SAINT PAUL ST STE 3100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-3923
Mailing Address - Country:US
Mailing Address - Phone:901-652-5702
Mailing Address - Fax:
Practice Address - Street 1:325 N SAINT PAUL ST STE 3100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-3923
Practice Address - Country:US
Practice Address - Phone:090-165-2570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)