Organization
KOUCH MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHIBUIKEM IHEANACHO (PRESIDENT)
(707) 421-1845
Entity
Organization
Contact information
Practice address
1325 TRAVIS BLVD, STE B, FAIRFIELD, CA 94533-4611
(707) 421-8145
(707) 421-8155
Mailing address
1325 TRAVIS BLVD, STE B, FAIRFIELD, CA 94533-4611
(707) 421-8145
(707) 421-8155
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/05/2006
Last updated
08/22/2020
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