Organization
KILGORE RESPIRATORY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRED BIETSCH (VICE PRESIDENT)
(573) 442-8338
Entity
Organization
Contact information
Practice address
626 E SUMMIT ST, SUITE A, MEXICO, MO 65265-3298
(573) 567-7999
(573) 567-7045
Mailing address
1815 CHAPEL HILL RD STE 210, COLUMBIA, MO 65203-5420
(573) 442-8338
(573) 446-5008
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
MO
332BX2000X
Oxygen Equipment & Supplies (DME)
—
MO
Other
Enumeration date
08/04/2015
Last updated
08/13/2019
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