Provider Demographics
NPI:1740206150
Name:KTL&C, LLC
Entity Type:Organization
Organization Name:KTL&C, LLC
Other - Org Name:RXPOSITIVE MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCHOLLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-344-9301
Mailing Address - Street 1:1845 W 25TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6929
Mailing Address - Country:US
Mailing Address - Phone:928-344-9301
Mailing Address - Fax:928-726-6168
Practice Address - Street 1:1845 W 25TH ST STE B
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6926
Practice Address - Country:US
Practice Address - Phone:928-344-9301
Practice Address - Fax:928-726-6168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20050753332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5313580001Medicare ID - Type UnspecifiedMEDICARE ID