Organization
KC HEALTHCARE SUPPLIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHINWE O'KOLI (CEO)
(678) 377-9660
Entity
Organization
Contact information
Practice address
5425 SUGARLOAF PKWY, SUITE#1100, LAWRENCEVILLE, GA 30043-5764
(678) 377-9660
(678) 377-9566
Mailing address
5425 SUGARLOAF PKWY, SUITE #1100, LAWRENCEVILLE, GA 30043-5764
(678) 377-9660
(678) 377-9566
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
07072500
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21677 PARENT ID 2292
CARECENTRIX
GA
05
—
645147770A
—
GA
Enumeration date
09/17/2007
Last updated
06/17/2011
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