Provider Demographics
NPI:1457656878
Name:KEY MEDICAL, INC.
Entity Type:Organization
Organization Name:KEY MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-757-0254
Mailing Address - Street 1:5401 LONGLEY LN
Mailing Address - Street 2:SUITE 10
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-1818
Mailing Address - Country:US
Mailing Address - Phone:775-236-0011
Mailing Address - Fax:775-236-0012
Practice Address - Street 1:5401 LONGLEY LN
Practice Address - Street 2:SUITE 10
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-1818
Practice Address - Country:US
Practice Address - Phone:775-236-0011
Practice Address - Fax:775-236-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-15
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV6550680001Medicare NSC