Provider Demographics
NPI:1942683073
Name:KW, INC.
Entity Type:Organization
Organization Name:KW, INC.
Other - Org Name:HOMETOWN MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KI OK
Authorized Official - Middle Name:
Authorized Official - Last Name:YOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-380-1599
Mailing Address - Street 1:2426 W 8TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3840
Mailing Address - Country:US
Mailing Address - Phone:213-380-1599
Mailing Address - Fax:213-380-3239
Practice Address - Street 1:2426 W 8TH ST STE 103
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3840
Practice Address - Country:US
Practice Address - Phone:213-380-1599
Practice Address - Fax:213-380-3239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76573332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies