Provider Demographics
NPI: | 1750491304 |
---|---|
Name: | EKK MEDICAL EQUIPMENT CORP. |
Entity Type: | Organization |
Organization Name: | EKK MEDICAL EQUIPMENT CORP. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | EVELYN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BALDRICHE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 786-316-8332 |
Mailing Address - Street 1: | 2371 W 80TH ST |
Mailing Address - Street 2: | UNIT 6 |
Mailing Address - City: | HIALEAH |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33016-5587 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 786-316-8332 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2371 W 80TH ST |
Practice Address - Street 2: | UNIT 6 |
Practice Address - City: | HIALEAH |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33016-5587 |
Practice Address - Country: | US |
Practice Address - Phone: | 786-316-8332 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-08-30 |
Last Update Date: | 2022-07-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332BX2000X | Suppliers | Durable Medical Equipment & Medical Supplies | Oxygen Equipment & Supplies |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | TAX ID | Other |