=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780640334
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KINDLE DRUG INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/24/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 504 SOUTH MAIN
-----------------------------------------------------
City | LINDALE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75771-0429
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-882-4375
-----------------------------------------------------
Fax | 903-882-0277
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 504 SOUTH MAIN PO BOX 429
-----------------------------------------------------
City | LINDALE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75771-0429
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-882-4375
-----------------------------------------------------
Fax | 903-882-0277
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER CEO
-----------------------------------------------------
Name | MR. KERRY ANTHONY KINDLE SR.
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 903-962-3900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------