Provider Demographics
NPI:1780075192
Name:EKNO SUPPLY LLC
Entity type:Organization
Organization Name:EKNO SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER / DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EARRON
Authorized Official - Middle Name:
Authorized Official - Last Name:STARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-635-7833
Mailing Address - Street 1:PO BOX 541765
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33454-1765
Mailing Address - Country:US
Mailing Address - Phone:561-635-7833
Mailing Address - Fax:561-792-6568
Practice Address - Street 1:3581 COLLONADE DR
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449-8081
Practice Address - Country:US
Practice Address - Phone:561-635-7833
Practice Address - Fax:561-792-6568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-08
Last Update Date:2015-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies