Kavanaugh Supplies LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

037068103 Issued in MS

Legal business name

KAVANAUGH SUPPLIES LLC

Practice address

22 98 Place Blvd
Suite 10
Hattiesburg, MS 39402-8603

Phone

(601) 296-6763

Fax

(601) 296-6764

NPI assigned

Jul 23, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John Kavanaugh

Title

Managing Member

Phone

(601) 296-6763

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Freedom Healthcare Doing business as

Locations

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244419200000",
    "number": "1942221973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 98 PLACE BLVD",
            "address_2": "SUITE 10",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028603",
            "telephone_number": "601-296-6763",
            "fax_number": "601-296-6764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 98 PLACE BLVD",
            "address_2": "SUITE 10",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028603",
            "telephone_number": "601-296-6763",
            "fax_number": "601-296-6764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAVANAUGH SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2009-06-08",
        "status": "A",
        "authorized_official_last_name": "KAVANAUGH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "601-296-6763",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "037068103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08876259",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freedom Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chami Kane, LPC
• Karah Hill Hiatt OD PLLC
• Karim'S, LLC.
• Tiffany Karoly
• Muhammad Kashif, MD
• Kay Route LLC
• Jacob Daniel Kay, MSN, RN, APRN, PMHNP
• Ekeista Keaton, FNP
• Florestine Keaton, PCCSS
• Scott A Keeler, M.D.

• Durable Medical Equipment & Medical Supplies in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; 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.