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General NPI Number Information
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NPI Number | 1104928977
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Entity Type | Organization
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Legal Business Name | KEGELCOMPARE LLC
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9405 S EASTERN AVE APT 1048
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City | LAS VEGAS
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State | NV
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Zip | 89123-3991
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Country | US
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Telephone | 702-759-2710
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Fax |
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Provider Business Mailing Address
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Address Line | 9405 S EASTERN AVE APT 1048
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City | LAS VEGAS
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State | NV
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Zip | 89123-3991
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Country | US
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Telephone | 702-759-2710
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | BRADLEY J PORTER
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Credential | RN
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Telephone | 702-759-2710
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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 | 608043
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License Number State | NV
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