Provider Demographics
NPI:1801307228
Name:KM REMODELING LLC
Entity type:Organization
Organization Name:KM REMODELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:B
Authorized Official - Last Name:MOEHLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-889-5626
Mailing Address - Street 1:7915 MAINLAND DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-5160
Mailing Address - Country:US
Mailing Address - Phone:210-680-5626
Mailing Address - Fax:210-680-5625
Practice Address - Street 1:7915 MAINLAND DR STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-5160
Practice Address - Country:US
Practice Address - Phone:210-680-5626
Practice Address - Fax:210-680-5625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment