Healthcare Provider Details

I. General information

NPI: 1558206490
Provider Name (Legal Business Name): KINOVA MEDICAL SUPPLY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12484 E WEAVER PL
CENTENNIAL CO
80111-5663
US

IV. Provider business mailing address

350 INDIANA ST STE 550
GOLDEN CO
80401-6569
US

V. Phone/Fax

Practice location:
  • Phone: 469-619-7814
  • Fax:
Mailing address:
  • Phone: 469-619-7814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: QUINTARIUS MCKINNIE
Title or Position: OWNER
Credential:
Phone: 469-619-7814