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General NPI Number Information
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NPI Number | 1780075192
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Entity Type | Organization
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Legal Business Name | EKNO SUPPLY LLC
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Dates
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Enumeration Date | 02/08/2015
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Last Update Date | 02/08/2015
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Provider Practice Location Address
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Address Line | 3581 COLLONADE DR
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City | WELLINGTON
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State | FL
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Zip | 33449-8081
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Country | US
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Telephone | 561-635-7833
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Fax | 561-792-6568
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Provider Business Mailing Address
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Address Line | PO BOX 541765
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City | GREENACRES
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State | FL
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Zip | 33454-1765
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Country | US
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Telephone | 561-635-7833
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Fax | 561-792-6568
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Authorized Official
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Title or Position | MANAGER / DIRECTOR
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Name | MR. EARRON STARKS
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Credential |
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Telephone | 561-635-7833
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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 |
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