MEDICARE: K.J., INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	A006004	KS

General Provider Information

NPI Number	:	1275751968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K.J., INC

Provider Business Mailing Address
First Line	:	736 HEYLMAN ST
Second Line	:	PO BOX 831
City	:	FORT SCOTT
State	:	KS
Zip	:	66701-2433
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	736 HEYLMAN ST
Second Line	:
City	:	FORT SCOTT
State	:	KS
Zip	:	66701-2433
Country	:	US
Telephone Number	:	620-224-2709
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR AND CEO
Name	:	WILLIAM R FISCHER
Credential	:	LNHA
Telephone Number	:	620-223-3120

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	08/22/2020

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