Provider Demographics
NPI:1790702660
Name:KS MARKETING INC
Entity Type:Organization
Organization Name:KS MARKETING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:UTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-960-9895
Mailing Address - Street 1:4210 MARCELLO DR
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-1661
Mailing Address - Country:US
Mailing Address - Phone:248-960-9895
Mailing Address - Fax:
Practice Address - Street 1:1006 BENSTEIN RD STE 106
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390-2912
Practice Address - Country:US
Practice Address - Phone:248-960-9895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX IDENIFCATION NUMBER
MI5296170001Medicare ID - Type UnspecifiedMEDICARE