Healthcare Provider Details

I. General information

NPI: 1700795309
Provider Name (Legal Business Name): KAY ROUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 MCINNIS LOOP APT 20
HATTIESBURG MS
39402-3404
US

IV. Provider business mailing address

2410 MCINNIS LOOP APT 20
HATTIESBURG MS
39402-3404
US

V. Phone/Fax

Practice location:
  • Phone: 216-547-9474
  • Fax:
Mailing address:
  • Phone: 720-702-2374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LATESHA KEYS
Title or Position: KAY ROUTE LLC
Credential:
Phone: 720-702-2374