Russell D Kornegor
Individual provider Active NPI Durable Medical Equipment & Medical Supplies · Coldwater, OH
NPI 1629250097 · NPPES record last updated Nov 28, 2007
Key facts
- NPI
- 1629250097
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- License
- HMEL.11296 (OH)
- Practice address
- 703 N 2ND St
Coldwater, OH 45828-9780 - Phone
- (419) 678-2168
- Fax
- (419) 678-8893
- NPI assigned
- Nov 28, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HMEL.11296 | OH | MD | Durable Medical Equipment & Medical Supplies |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Russell Kornegor Medical Equipment LTD | Durable Medical Equipment & Medical Supplies | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | HMEL.11296 | OH | Yes |
Addresses
Primary practice location
703 N 2ND St
Coldwater, OH 45828-9780
Mailing address
703 N 2ND St
Coldwater, OH 45828-9780
Phone (419) 678-2168
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000283155 | Other | OH | ANTHEM |
| 2324701 | Medicaid | OH |
Other providers in Coldwater, OH
- Diane Klenke
- Curtis B. Kline
- Tracy Klosterman
- Haley Knapke
- Erin Koesters
- Cathy Kosboth
- Lindsey A Lamm
- Paul Henry Langenkamp
- Amy Lehman
- Matthew Daniel Lemmerman
All providers in Coldwater, OH · Durable Medical Equipment & Medical Supplies in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.