Organization
JERRY IKE
Active
Other names
KENLINK MEDICAL EQUIPMENT & SUPPLIE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY J IKE (PRESIDENT)
(972) 262-7752
Entity
Organization
Contact information
Practice address
2306 OAK LN., STE 16, GRAND PRAIRIE, TX 75051
(972) 262-7752
(972) 237-0430
Mailing address
2306 OAK LN., STE 16, GRAND PRAIRIE, TX 75051
(972) 262-7752
(972) 237-0430
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0071940
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TPI 170054401
—
TX
05
—
TPI 170054402
—
TX
Enumeration date
10/31/2005
Last updated
11/23/2010
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