Organization
KTM HEALTH CARE INC
Active
Other names
Enterprise Valley Closed
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM KATSCHKE (PRESIDENT)
(801) 592-1056
Entity
Organization
Contact information
Practice address
660 E MAIN ST B700, BLDG A, ENTERPRISE, UT 84725-0700
(435) 878-2760
(435) 878-2765
Mailing address
PO BOX 761, CALIENTE, NV 89008-0761
(775) 726-3771
(775) 726-3685
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
76644571704
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4611807
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/26/2010
Last updated
10/04/2011
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