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General NPI Number Information
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NPI Number | 1043660137
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Entity Type | Organization
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Legal Business Name | KIMBERLY RUTH MEDICAL SUPPLIES & EQUIP.
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Dates
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Enumeration Date | 06/20/2016
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Last Update Date | 06/20/2016
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Provider Practice Location Address
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Address Line | 516 DEVONIA ST
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City | HARRIMAN
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State | TN
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Zip | 37748-2115
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Country | US
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Telephone | 865-590-7993
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Fax |
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Provider Business Mailing Address
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Address Line | 516 DEVONIA ST
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City | HARRIMAN
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State | TN
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Zip | 37748-2115
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Country | US
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Telephone | 865-590-7993
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHRISTOPHER CALEB MULLINS
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Credential |
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Telephone | 865-590-7993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1247
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License Number State | TN
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