Organization
DEK HEALTH ALLIANCE LLC
Active
Other names
appalachian medical
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA S KIDD R.R.T (OWNER/PRESIDENT)
(606) 256-4013
Entity
Organization
Contact information
Practice address
127 KINGSWOOD DR, CAMPBELLSVILLE, KY 42718-9634
(270) 469-1335
(270) 469-1336
Mailing address
PO BOX 929, 45 NEWCOMB AVENUE, MOUNT VERNON, KY 40456-0929
(606) 256-4013
(606) 256-1242
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
MG0543
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90007998
—
KY
01
—
CO8405418
DMERC SUBMITTER M/C EDI
KY
Enumeration date
05/08/2006
Last updated
08/22/2020
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