Organization
KILGORE RESPIRATORY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY ANN BIETSCH RRT (PRESIDENT)
(573) 424-0202
Entity
Organization
Contact information
Practice address
1815 CHAPEL HILL RD STE 210, COLUMBIA, MO 65203-5420
(573) 442-8338
(573) 446-5008
Mailing address
1815 CHAPEL HILL RD STE 210, COLUMBIA, MO 65203-5420
(573) 442-8338
(573) 446-5008
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
626359806
—
MO
Enumeration date
10/09/2007
Last updated
08/13/2019
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