Provider Demographics
NPI:1184951626
Name:AKBK INC.
Entity type:Organization
Organization Name:AKBK INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:KOSLOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:865-675-2873
Mailing Address - Street 1:4503 WALKER BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-1526
Mailing Address - Country:US
Mailing Address - Phone:865-688-2626
Mailing Address - Fax:865-688-3647
Practice Address - Street 1:314 HOME AVE
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-3971
Practice Address - Country:US
Practice Address - Phone:865-984-2580
Practice Address - Fax:865-984-2582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNORT0000000031335E00000X
TNPRO0000000027335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4255379OtherBLUE CROSS BLUE SHEILD
TN4255379OtherBLUE CROSS BLUE SHEILD