Organization
MEDICAL PARK HOME EQUIPMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. A JEFFREY DENTON RPH (PRESIDENT)
(620) 793-7828
Entity
Organization
Contact information
Practice address
4010 10TH ST, GREAT BEND, KS 67530-3436
(620) 793-7828
Mailing address
4010 10TH ST, GREAT BEND, KS 67530-3436
(620) 793-7828
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100441390A
—
KS
Enumeration date
08/18/2005
Last updated
12/14/2010
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