Organization
KELLCO MEDICAL EQUIPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY L KELLEY (OWNER/CEO)
(706) 237-7223
Entity
Organization
Contact information
Practice address
1903 TURNER MCCALL BLVD SE, ROME, GA 30161-3366
(706) 237-7223
Mailing address
1903 TURNER MCCALL BLVD SE, ROME, GA 30161-3366
(706) 237-7223
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054860421
STATE OF GEORGIA
GA
Enumeration date
04/03/2019
Last updated
04/03/2019
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