Provider Demographics
NPI:1275645582
Name:RESOURCE DME, INC.
Entity Type:Organization
Organization Name:RESOURCE DME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-528-3105
Mailing Address - Street 1:629 MARKET ST
Mailing Address - Street 2:PO BOX 151
Mailing Address - City:OSAGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66523-1159
Mailing Address - Country:US
Mailing Address - Phone:785-528-0144
Mailing Address - Fax:785-528-0124
Practice Address - Street 1:629 MARKET ST
Practice Address - Street 2:
Practice Address - City:OSAGE CITY
Practice Address - State:KS
Practice Address - Zip Code:66523-1159
Practice Address - Country:US
Practice Address - Phone:785-528-0144
Practice Address - Fax:785-528-0124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS004-F-01332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100400650AMedicaid
KS100400650BMedicaid
KS118037OtherBC/BS OF KANSAS PROVIDER
KS118037OtherBC/BS OF KANSAS PROVIDER