Provider Demographics
NPI:1730908740
Name:MUKISS LLC
Entity type:Organization
Organization Name:MUKISS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUM
Authorized Official - Suffix:
Authorized Official - Credentials:MIS
Authorized Official - Phone:614-749-1126
Mailing Address - Street 1:1747 OLENTANGY RIVER RD # 1095
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-1453
Mailing Address - Country:US
Mailing Address - Phone:614-749-1126
Mailing Address - Fax:
Practice Address - Street 1:1747 OLENTANGY RIVER RD # 1095
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-1453
Practice Address - Country:US
Practice Address - Phone:614-749-1126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332U00000XSuppliersHome Delivered Meals