Provider Demographics
NPI:1881493047
Name:KSC ENTERPRISES LLC
Entity type:Organization
Organization Name:KSC ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPARTMENT HEAD
Authorized Official - Prefix:
Authorized Official - First Name:KHURRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHZAD
Authorized Official - Suffix:
Authorized Official - Credentials:EXECUTIVE MEMBER
Authorized Official - Phone:703-774-1821
Mailing Address - Street 1:10217 MCKEAN CT
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-4204
Mailing Address - Country:US
Mailing Address - Phone:703-774-1821
Mailing Address - Fax:
Practice Address - Street 1:1220 OAK ST STE J
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-1072
Practice Address - Country:US
Practice Address - Phone:703-774-1821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies