Provider Demographics
NPI:1386827418
Name:KAL MEDICAL SUPPLIES INC.
Entity Type:Organization
Organization Name:KAL MEDICAL SUPPLIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:KALESI
Authorized Official - Last Name:NWIBIABU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-266-9545
Mailing Address - Street 1:621 W 3900 S STE A100
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84123-1347
Mailing Address - Country:US
Mailing Address - Phone:877-266-9545
Mailing Address - Fax:801-293-9150
Practice Address - Street 1:621 W 3900 S STE A100
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84123-1347
Practice Address - Country:US
Practice Address - Phone:877-266-9545
Practice Address - Fax:801-293-9150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT332B00000X
UT6814204-1714332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT6207850001Medicare NSC