Provider Demographics
NPI:1205376233
Name:KINEX MEDICAL COMPANY, LLC
Entity type:Organization
Organization Name:KINEX MEDICAL COMPANY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BUCKHOLDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-845-6364
Mailing Address - Street 1:1801 AIRPORT RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-2477
Mailing Address - Country:US
Mailing Address - Phone:800-845-6364
Mailing Address - Fax:
Practice Address - Street 1:1940 COMMERCE CENTER BLVD UNIT A-402
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-6363
Practice Address - Country:US
Practice Address - Phone:800-845-6364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-23
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies