Provider Demographics
NPI:1457366874
Name:MCKINLAY ENTERPRISES INC
Entity Type:Organization
Organization Name:MCKINLAY ENTERPRISES INC
Other - Org Name:THE BONE STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:KARTER
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCKINLAY
Authorized Official - Suffix:
Authorized Official - Credentials:COF
Authorized Official - Phone:559-226-7500
Mailing Address - Street 1:343 E SHAW AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7609
Mailing Address - Country:US
Mailing Address - Phone:559-226-7500
Mailing Address - Fax:559-226-1613
Practice Address - Street 1:343 E SHAW AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7609
Practice Address - Country:US
Practice Address - Phone:559-226-7500
Practice Address - Fax:559-226-1613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103216335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4790000001Medicare NSC