MEDICARE: KB COLLECTION LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1437912086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KB COLLECTION LLC

Provider Business Mailing Address
First Line	:	3250A W 86TH ST # 1026
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-3605
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3250A W 86TH ST # 1026
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-3605
Country	:	US
Telephone Number	:	317-406-9775
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KEIONYA BOLAR
Credential	:
Telephone Number	:	317-406-9775

Provider Enumeration Date	:	02/05/2024
Last Update Date	:	02/05/2024

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Directions to “KB COLLECTION LLC ” Practice Location

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