Organization
RUSSELL KORNEGOR MEDICAL EQUIPMENT LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL DEAN KORNEGOR (OWNER)
(419) 678-2168
Entity
Organization
Contact information
Practice address
703 N 2ND ST, COLDWATER, OH 45828-9780
(419) 678-2168
(419) 678-8893
Mailing address
703 N 2ND ST, COLDWATER, OH 45828-9780
(419) 678-2168
(419) 678-8893
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2324701
—
OH
Enumeration date
04/11/2007
Last updated
11/16/2007
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