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General NPI Number Information
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NPI Number | 1528182466
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Entity Type | Organization
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Legal Business Name | KANDIE MEDICAL SUPPLY
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Dates
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Enumeration Date | 03/18/2007
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Last Update Date | 07/25/2012
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Provider Practice Location Address
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Address Line | 17300 DASHWOOD CREEK DR
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-5712
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Country | US
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Telephone | 512-740-7867
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Fax | 512-233-5957
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Provider Business Mailing Address
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Address Line | 17300 DASHWOOD CREEK DR
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-5712
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Country | US
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Telephone | 512-740-7867
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Fax | 512-233-5957
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Authorized Official
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Title or Position | DIRECTOR
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Name | CHRISTINA N NEWSOME
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Credential |
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Telephone | 512-740-7867
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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 |
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License Number State | TX
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