Provider Demographics
NPI:1568646651
Name:CKC DURABLE MEDICAL SUPPLIES, LLC
Entity Type:Organization
Organization Name:CKC DURABLE MEDICAL SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER / MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:IBE
Authorized Official - Middle Name:UGONNA
Authorized Official - Last Name:NNAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-867-1717
Mailing Address - Street 1:4104 AIRPORT HWY
Mailing Address - Street 2:4040 PLAZA
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-7100
Mailing Address - Country:US
Mailing Address - Phone:419-382-7050
Mailing Address - Fax:419-382-7051
Practice Address - Street 1:4104 AIRPORT HWY
Practice Address - Street 2:4040 PLAZA
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-7100
Practice Address - Country:US
Practice Address - Phone:419-382-7050
Practice Address - Fax:419-382-7051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies