Organization
LORIQUEN HOLDINGS DBA KINKISTRY
Active
Parent organization
LORIQUEN HOLDINGS
Organization subpart
Yes
Provider details
NPI number
Legal business name
LORIQUEN HOLDINGS
Authorized official
ANGELA FITE (OWNER)
(404) 416-3818
Entity
Organization
Contact information
Practice address
5623 VININGS PLACE TRL, MABLETON, GA 30126-5681
(404) 416-3818
Mailing address
5623 VININGS PLACE TRL, MABLETON, GA 30126-5681
(404) 416-3818
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123456
CAQH
GA
Enumeration date
10/15/2021
Last updated
10/15/2021
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