Provider Demographics
NPI:1114566767
Name:NK MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:NK MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KAMAL
Authorized Official - Middle Name:IBRAHIM
Authorized Official - Last Name:ABDELRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-842-6545
Mailing Address - Street 1:4880 NW 22ND ST APT 101
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-3411
Mailing Address - Country:US
Mailing Address - Phone:954-842-6545
Mailing Address - Fax:
Practice Address - Street 1:4880 NW 22ND ST APT 101
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-3411
Practice Address - Country:US
Practice Address - Phone:954-842-6545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-30
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies