Healthcare Provider Details

I. General information

NPI: 1619061686
Provider Name (Legal Business Name): K-A MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RT 44 SOUTH WILKINSON
WILKINSON WV
25653
US

IV. Provider business mailing address

PO BOX 202
STOLLINGS WV
25646-0202
US

V. Phone/Fax

Practice location:
  • Phone: 304-752-2115
  • Fax: 304-752-5934
Mailing address:
  • Phone: 304-752-2115
  • Fax: 304-752-5934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateWV

VIII. Authorized Official

Name: MS. CAROL ANN CRADDOCK
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 304-752-2115