Organization
KIMCO MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DEKUNLE R SHITTU (CEO)
(909) 381-1948
Entity
Organization
Contact information
Practice address
577 N D ST, SUITE 113, SAN BERNARDINO, CA 92401-1324
(909) 381-1948
(909) 381-1959
Mailing address
577 N D ST, SUITE 113, SAN BERNARDINO, CA 92401-1324
(909) 381-1948
(909) 381-1959
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5471060001
CA
Other
Enumeration date
06/26/2006
Last updated
08/22/2020
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