Provider Demographics
NPI:1720182330
Name:KATHY J ADAMS
Entity Type:Organization
Organization Name:KATHY J ADAMS
Other - Org Name:KATHCO MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:ORTHODICS
Authorized Official - Phone:724-589-0262
Mailing Address - Street 1:PO BOX 286
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16125-0286
Mailing Address - Country:US
Mailing Address - Phone:724-589-0262
Mailing Address - Fax:724-589-5975
Practice Address - Street 1:39 HADLEY RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:PA
Practice Address - Zip Code:16125-1239
Practice Address - Country:US
Practice Address - Phone:724-589-0262
Practice Address - Fax:724-589-5975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAC18354332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2208873Medicaid
1313050001Medicare NSC