MEDICARE: KNJ HOLDINGS 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	:	1538779210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KNJ HOLDINGS LLC

Provider Business Mailing Address
First Line	:	5605 FM 423 PMB 361
Second Line	:	STE 500
City	:	FRISCO
State	:	TX
Zip	:	75036
Country	:	US
Telephone Number	:	702-808-6564
Fax Number	:

Provider Business Practice Location Address
First Line	:	4014 ARBOR GROVE TRL
Second Line	:
City	:	MIDLOTHIAN
State	:	TX
Zip	:	76065-1788
Country	:	US
Telephone Number	:	702-808-6564
Fax Number	:

Authorized Official
Title or Position	:	CO-FOUNDER/ OWNER
Name	:	BRETT N PERRY
Credential	:
Telephone Number	:	702-808-6564

Provider Enumeration Date	:	08/06/2020
Last Update Date	:	08/06/2020

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Directions to “KNJ HOLDINGS LLC ” Practice Location

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