Organization
KANSAS MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON W, HULVEY PHARM.D. (OWNER/PRESIDENT)
(620) 429-1999
Entity
Organization
Contact information
Practice address
217 S KANSAS AVE, COLUMBUS, KS 66725
(620) 429-1999
(620) 429-1980
Mailing address
217 SOUTH KANSAS AVE, COLUMBUS, KS 66725
(620) 429-1999
(620) 429-1980
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
16-00454
KS
332BX2000X
Oxygen Equipment & Supplies (DME)
16-00454
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16-00454
KANSAS STATE BOARD OF PHARMACY - DME LICENSE NUMBER
KS
Enumeration date
12/20/2010
Last updated
12/20/2010
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