Provider Demographics
NPI:1437322484
Name:KENNETH G WOLF
Entity Type:Organization
Organization Name:KENNETH G WOLF
Other - Org Name:WOLF FURNITURE GALLERIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PRESTON
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-625-4800
Mailing Address - Street 1:4313 N VINE ST
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-9484
Mailing Address - Country:US
Mailing Address - Phone:785-625-4800
Mailing Address - Fax:785-625-4950
Practice Address - Street 1:4313 N VINE ST
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-9484
Practice Address - Country:US
Practice Address - Phone:785-625-4800
Practice Address - Fax:785-625-4950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies