K & K Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

5954070001 Issued in CA

Legal business name

K & K MEDICAL SUPPLY INC

Practice address

17410 Foothill Blvd
Suite C
Fontana, CA 92335-3651

Phone

(909) 356-4888

Fax

(909) 356-4920

NPI assigned

Dec 15, 2006

Last updated

Nov 6, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kim J Shittu

Title

President

Phone

(909) 356-4888

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1710049747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17410 FOOTHILL BLVD",
            "address_2": "SUITE C",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353651",
            "telephone_number": "909-356-4888",
            "fax_number": "909-356-4920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17410 FOOTHILL BLVD",
            "address_2": "SUITE C",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353651",
            "telephone_number": "909-356-4888",
            "fax_number": "909-356-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K & K MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "SHITTU",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-356-4888",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "5954070001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Fontana, CA
• Providers in Fontana, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.