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General NPI Number Information
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NPI Number | 1093197055
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Entity Type | Organization
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Legal Business Name | KAY'S MEDICAL SUPPLIES LLC
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Dates
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Enumeration Date | 06/25/2015
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 950 HERRINGTON RD STE C175
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-7217
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Country | US
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Telephone | 770-875-9329
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Fax |
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Provider Business Mailing Address
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Address Line | 950 HERRINGTON RD STE C175
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-7217
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Country | US
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Telephone | 770-875-9329
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAYODE OKUSI
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Credential |
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Telephone | 770-875-9329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BD1200X
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Taxonomy Name | Dialysis Equipment & Supplies (DME)
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License Number |
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License Number State |
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