Organization
KINETIX MEDICAL EQUIPMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN C SUDDUTH (CEO)
(662) 207-2711
Entity
Organization
Contact information
Practice address
21 S FOURTH ST, ROLLING FORK, MS 39159-5146
(662) 873-9222
(662) 873-9221
Mailing address
PO BOX 520, ROLLING FORK, MS 39159-0520
(662) 873-9222
(662) 873-9221
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440262
—
MS
Enumeration date
03/20/2013
Last updated
03/20/2013
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