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General NPI Number Information
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NPI Number | 1073759007
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Entity Type | Organization
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Legal Business Name | EKEH LLC
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Dates
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Enumeration Date | 12/22/2008
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Last Update Date | 12/22/2008
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Provider Practice Location Address
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Address Line | 7040 BROADWAY
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City | MERRILLVILLE
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State | IN
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Zip | 46410-3538
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Country | US
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Telephone | 219-472-0708
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Fax | 219-472-0044
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Provider Business Mailing Address
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Address Line | 7040 BROADWAY
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City | MERRILLVILLE
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State | IN
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Zip | 46410-3538
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Country | US
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Telephone | 219-472-0708
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Fax | 219-472-0044
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Authorized Official
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Title or Position | MD
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Name | MR. ALEXANDER KELECHI EKEH
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Credential | RN
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Telephone | 219-472-0708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0131070630
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 0131070630
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License Number State | IN
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