Konaniah Medical Equipment & Supplies LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

802292943 Issued in TX

Legal business name

KONANIAH MEDICAL EQUIPMENT & SUPPLIES LLC

Practice address

2304 Oak Lane
Suite 207
Grand Prairie, TX 75051-8816

Phone

(469) 610-5006

Fax

(210) 941-0082

NPI assigned

Sep 22, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Oluwole O Davids

Title

Owner

Phone

(469) 610-5006

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461628800000",
    "number": "1164891925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 OAK LANE",
            "address_2": "SUITE 207",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750518816",
            "telephone_number": "469-610-5006",
            "fax_number": "210-941-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 OAK LANE",
            "address_2": "SUITE 207",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750518816",
            "telephone_number": "469-610-5006",
            "fax_number": "210-941-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONANIAH MEDICAL EQUIPMENT & SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-22",
        "last_updated": "2016-04-26",
        "status": "A",
        "authorized_official_last_name": "DAVIDS",
        "authorized_official_first_name": "OLUWOLE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-610-5006",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "802292943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen A Koger, OT
• Chelsea Mae Kohutek, DC
• Sowmya Kokku
• Omolayo Kolleade
• Titilope J Komolafe
• Moya Nadege Koua
• Koyas LLC
• Martin Kram, M.D.
• Stephanie Krawietz, DPT
• Thomas William Kretchun, DDS

• Durable Medical Equipment & Medical Supplies in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.