MEDICARE: KD MEDICAL, 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	332BX2000X	Oxygen Equipment & Supplies (DME)	40498.20000	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811089956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KD MEDICAL, LLC

Provider Business Mailing Address
First Line	:	8188 S MEMPHIS WAY
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80112-4625
Country	:	US
Telephone Number	:	720-323-4727
Fax Number	:	303-690-5654

Provider Business Practice Location Address
First Line	:	1925 S ROSEMARY ST
Second Line	:	SUITE D
City	:	DENVER
State	:	CO
Zip	:	80231-3238
Country	:	US
Telephone Number	:	720-747-5395
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MARC KRYZANOWSKI
Credential	:
Telephone Number	:	720-747-5395

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	08/22/2020

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Directions to “KD MEDICAL, LLC ” Practice Location

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