Provider Demographics
NPI:1669682001
Name:KMM HOME CARE CONNECTION LLC
Entity Type:Organization
Organization Name:KMM HOME CARE CONNECTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BUCKNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-462-0077
Mailing Address - Street 1:242 HARDING WAY E
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-2001
Mailing Address - Country:US
Mailing Address - Phone:419-462-0077
Mailing Address - Fax:419-462-0406
Practice Address - Street 1:242 HARDING WAY E
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-2001
Practice Address - Country:US
Practice Address - Phone:419-462-0077
Practice Address - Fax:419-462-0406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health