Organization
FAMILY MEDICAL SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA RENE SMITH (OFFICE MANAGER)
(316) 744-1261
Entity
Organization
Contact information
Practice address
1542 E 61ST ST N, PARK CITY, KS 67219-1953
(316) 744-1261
(316) 744-3443
Mailing address
1542 E 61ST ST N, PARK CITY, KS 67219-1953
(316) 744-1261
(316) 744-3443
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118064
BLUE CROSS/BLUE SHIELD
KS
Enumeration date
05/08/2006
Last updated
08/22/2020
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