Organization
J & S KELLY LLC
Active
Other names
Kelly's Medical Equipment & Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM M KELLENBERGER (OWNER)
(563) 386-1553
Entity
Organization
Contact information
Practice address
229 S MAIN ST, KEWANEE, IL 61443-2861
(309) 856-5870
(309) 854-0728
Mailing address
730 E KIMBERLY RD, DAVENPORT, IA 52807-1621
(563) 386-1553
(563) 391-7702
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
203.000827
IL
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
1254070004
IL
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
07/13/2006
Last updated
07/27/2010
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