Provider Demographics
NPI:1811596901
Name:KD MEDICAL INC
Entity type:Organization
Organization Name:KD MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEDD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-720-0546
Mailing Address - Street 1:1130 E CLARK AVE STE 150-287
Mailing Address - Street 2:
Mailing Address - City:ORCUTT
Mailing Address - State:CA
Mailing Address - Zip Code:93455-5178
Mailing Address - Country:US
Mailing Address - Phone:805-720-0546
Mailing Address - Fax:
Practice Address - Street 1:4565 MONACO CT
Practice Address - Street 2:
Practice Address - City:ORCUTT
Practice Address - State:CA
Practice Address - Zip Code:93455-4073
Practice Address - Country:US
Practice Address - Phone:805-720-0546
Practice Address - Fax:805-937-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies