# KNC MEDICAL SUPPLY, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578595641
- **Authorized official:** MR. OKEY OKAFOR N/A (MANAGING DIRECTOR)
- **Authorized official phone:** (323) 299-0837

## Contact information

- **Practice address:** 3931 W SLAUSON AVE, LOS ANGELES, CA 90043-2976
- **Practice address phone:** (323) 299-0837
- **Mailing address:** 4718 S MULLEN AVE, LOS ANGELES, CA 90043-1718
- **Mailing address phone:** (323) 299-0837
- **Mailing address fax:** (323) 299-0839

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | DME03143G | CA | Yes |
| 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