Organization
KOVINE MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KPOTO OKON ISANGEDIGHI (OWNER)
(336) 389-9343
Entity
Organization
Contact information
Practice address
620 S ELM ST, STE 374, GREENSBORO, NC 27406-1398
(336) 398-9343
(336) 389-9334
Mailing address
620 S ELM ST, STE 374, GREENSBORO, NC 27406-1398
(336) 398-9343
(336) 389-9334
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
600442227
NC
Other
Enumeration date
08/09/2005
Last updated
03/04/2010
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