Organization
KCC, INC.
Active
Other names
Vital Care of Meridian/ West Alabama
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD GILCHRIST (COO)
(601) 482-4003
Entity
Organization
Contact information
Practice address
1501 23RD AVE, MERIDIAN, MS 39301-4586
(601) 482-4003
(601) 482-3948
Mailing address
1501 23RD AVE, MERIDIAN, MS 39301-4027
(601) 482-4003
(601) 482-3948
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
111985
AL
332BC3200X
Customized Equipment (DME)
111985
AL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
111985
AL
332BX2000X
Oxygen Equipment & Supplies (DME)
111985
AL
333600000X
Pharmacy
111985
AL
3336C0003X
Community/Retail Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000404202
—
MS
05
—
000057068
—
AL
05
—
00330015
—
MS
01
—
01-25941
NCPDP
—
05
—
100002498
—
AL
01
—
104747300
OWCP
—
01
—
25-86014
NCPDP
—
01
—
510-43792
BCBS
AL
01
—
515-02164
BCBS - DME
AL
01
—
870001313
MEDICARE LOCAL PART B
MS
01
—
P00105652
MEDICARE RR
MS
Enumeration date
07/11/2006
Last updated
11/24/2025
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