MEDICARE: DJKIERL, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	310400000X	Assisted Living Facility
3	3140N1450X	Pediatric Skilled Nursing Facility
4	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1558554881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DJKIERL, INC.

Provider Business Mailing Address
First Line	:	214 S. 10TH ST
Second Line	:
City	:	MOUND CITY
State	:	KS
Zip	:	66056-5265
Country	:	US
Telephone Number	:	913-795-2637
Fax Number	:	913-795-2637

Provider Business Practice Location Address
First Line	:	736 HEYLMAN ST
Second Line	:
City	:	FORT SCOTT
State	:	KS
Zip	:	66701-2433
Country	:	US
Telephone Number	:	620-223-3120
Fax Number	:	620-223-1560

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RAYMOND D. KIERL
Credential	:
Telephone Number	:	913-795-2637

Provider Enumeration Date	:	08/21/2007
Last Update Date	:	03/26/2014

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Directions to “DJKIERL, INC. ” Practice Location

Language	Start Address	Practice Location

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