Provider Demographics
NPI:1437253747
Name:KKRUEGER CORPORATION
Entity Type:Organization
Organization Name:KKRUEGER CORPORATION
Other - Org Name:KRUEGER HEALTHCARE PRODUCTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-692-0440
Mailing Address - Street 1:19195 SW TETON AVE
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-8858
Mailing Address - Country:US
Mailing Address - Phone:503-692-0440
Mailing Address - Fax:503-723-8620
Practice Address - Street 1:19195 SW TETON AVE
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-8858
Practice Address - Country:US
Practice Address - Phone:503-692-0440
Practice Address - Fax:503-723-8620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR5682840001Medicare ID - Type Unspecified