Organization
FOX MED-EQUIP SERVICE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LYNETTE MICHELLE KAMAN (CEO)
(618) 345-0649
Entity
Organization
Contact information
Practice address
1832 VANDALIA ST, COLLINSVILLE, IL 62234-1490
(618) 345-0649
(618) 345-0694
Mailing address
1832 VANDALIA ST, COLLINSVILLE, IL 62234-1490
(618) 345-0649
(618) 345-0694
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
622114007
—
MO
Enumeration date
01/12/2006
Last updated
10/11/2012
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