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Organization
KNC MEDICAL SUPPLY, INC
Active
Organization
KNC MEDICAL SUPPLY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OKEY OKAFOR N/A (MANAGING DIRECTOR)
(323) 299-0837
Entity
Organization
Contact information
Practice address
3931 W SLAUSON AVE, LOS ANGELES, CA 90043-2976
(323) 299-0837
Mailing address
4718 S MULLEN AVE, LOS ANGELES, CA 90043-1718
(323) 299-0837
(323) 299-0839
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
DME03143G
CA
332BC3200X
Customized Equipment (DME)
DME03143G
CA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
DME03143G
CA
Other
Enumeration date
07/07/2006
Last updated
10/26/2021
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