Provider Demographics
NPI:1093197055
Name:KAY'S MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:KAY'S MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAYODE
Authorized Official - Middle Name:
Authorized Official - Last Name:OKUSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-875-9329
Mailing Address - Street 1:950 HERRINGTON RD
Mailing Address - Street 2:STE C175
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-7217
Mailing Address - Country:US
Mailing Address - Phone:770-875-9329
Mailing Address - Fax:
Practice Address - Street 1:950 HERRINGTON RD
Practice Address - Street 2:STE C175
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-7217
Practice Address - Country:US
Practice Address - Phone:770-875-9329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies