Organization
3 KB S ENTERPRISE INC CORPORATION
Active
Other names
INDIANA MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
ABIGAIL BUENCONSEJO OTR (MANAGER)
(260) 489-9533
Entity
Organization
Contact information
Practice address
2870 E DUPONT RD, FORT WAYNE, IN 46825-1669
(260) 489-9533
(260) 497-9088
Mailing address
2870 E DUPONT RD, FORT WAYNE, IN 46825-1669
(260) 489-9533
(260) 497-9088
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
04/22/2010
Last updated
10/03/2011
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