Provider Demographics
NPI:1598859944
Name:KND MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:KND MEDICAL SUPPLIES INC
Other - Org Name:GRANDIFF MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IMAOBONG
Authorized Official - Middle Name:
Authorized Official - Last Name:AKPAETE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-816-9100
Mailing Address - Street 1:11631 NEBEL STREET
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20904
Mailing Address - Country:US
Mailing Address - Phone:301-816-9100
Mailing Address - Fax:301-816-9100
Practice Address - Street 1:11631 NEBEL STREET
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20904
Practice Address - Country:US
Practice Address - Phone:301-816-9100
Practice Address - Fax:301-816-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2253P332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5604950001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER