KC Healthcare Supplies LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

07072500 Issued in GA

Legal business name

KC HEALTHCARE SUPPLIES LLC

Practice address

5425 Sugarloaf Pkwy
Suite#1100
Lawrenceville, GA 30043-5764

Phone

(678) 377-9660

Fax

(678) 377-9566

NPI assigned

Sep 17, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Chinwe O'Koli

Title

Ceo

Phone

(678) 377-9660

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308268800000",
    "number": "1982890653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 SUGARLOAF PKWY",
            "address_2": "SUITE #1100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435764",
            "telephone_number": "678-377-9660",
            "fax_number": "678-377-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 SUGARLOAF PKWY",
            "address_2": "SUITE#1100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435764",
            "telephone_number": "678-377-9660",
            "fax_number": "678-377-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KC HEALTHCARE SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-17",
        "last_updated": "2011-06-17",
        "status": "A",
        "authorized_official_last_name": "O'KOLI",
        "authorized_official_first_name": "CHINWE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-377-9660",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "07072500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARECENTRIX",
            "identifier": "21677 PARENT ID 2292",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "645147770A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; 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.