Provider Demographics
NPI:1609115252
Name:KM MEDICAL SUPPLY
Entity Type:Organization
Organization Name:KM MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATARZYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIATEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-841-5397
Mailing Address - Street 1:260 JOHN ST
Mailing Address - Street 2:APT 2
Mailing Address - City:SOUTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08879-1742
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:260 JOHN ST
Practice Address - Street 2:APT 2
Practice Address - City:SOUTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08879-1742
Practice Address - Country:US
Practice Address - Phone:732-841-5397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies