Provider Demographics
NPI:1942471545
Name:KNOVA'S CARPETS, INC.
Entity Type:Organization
Organization Name:KNOVA'S CARPETS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:L
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-276-9545
Mailing Address - Street 1:2500 GLENN AVE
Mailing Address - Street 2:SUITE 40
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-2762
Mailing Address - Country:US
Mailing Address - Phone:712-276-9545
Mailing Address - Fax:712-276-9532
Practice Address - Street 1:2500 GLENN AVE
Practice Address - Street 2:SUITE 40
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-2762
Practice Address - Country:US
Practice Address - Phone:712-276-9545
Practice Address - Fax:712-276-9532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-22
Last Update Date:2008-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0267666Medicaid