Organization
BRUNER TAMMY
Active
Other names
Kem Kare
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY R BRUNER RN (RN OWNER)
(574) 269-3306
Entity
Organization
Contact information
Practice address
119 N BALDWIN AVE, MARION, IN 46952
(765) 664-7463
Mailing address
30 EMS C30 LANE, WARSAW, IN 46582
(574) 269-3306
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
28060524A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000097375
BLUE CROSS BLUE SHIELD
IN
05
—
100124200A
—
IN
Enumeration date
10/12/2006
Last updated
06/19/2008
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