Provider Demographics
NPI:1871639716
Name:KING'S MEDICAL SUPPLY
Entity Type:Organization
Organization Name:KING'S MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ENO
Authorized Official - Middle Name:B
Authorized Official - Last Name:OKON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-830-1952
Mailing Address - Street 1:2118 WAR ADMIRAL DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-6345
Mailing Address - Country:US
Mailing Address - Phone:821-830-1952
Mailing Address - Fax:281-261-0273
Practice Address - Street 1:2118 WAR ADMIRAL DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-6345
Practice Address - Country:US
Practice Address - Phone:821-830-1952
Practice Address - Fax:281-261-0273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies