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General NPI Number Information
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NPI Number | 1669747572
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Entity Type | Organization
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Legal Business Name | KIMCOLE INC
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Dates
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Enumeration Date | 03/12/2012
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Last Update Date | 03/12/2012
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Provider Practice Location Address
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Address Line | 100 WASHINGTON ST SUITE LL-20
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City | RENO
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State | NV
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Zip | 89503-5686
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Country | US
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Telephone | 775-825-4663
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Fax | 866-357-6688
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Provider Business Mailing Address
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Address Line | 100 WASHINGTON ST SUITE LL-20
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City | RENO
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State | NV
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Zip | 89503-5686
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Country | US
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Telephone | 775-825-4663
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Fax | 866-357-6688
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Authorized Official
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Title or Position | ADMINASTRATOR
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Name | MS. NICOLE MARIE SIMPSON
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Credential |
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Telephone | 775-825-4663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 5384PCS-2
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License Number State | NV
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