Kimbo Medical Distributor in Wilmington - Parenteral & Enteral Nutrition
Kimbo Medical Distributor - NPI 1891916367
Kimbo Medical Distributor is a Parenteral & Enteral Nutrition in Wilmington, California. Kimbo Medical Distributor practices all healthcare services and medical treatments related to Parenteral & Enteral Nutrition. The NPI Number for Kimbo Medical Distributor is 1891916367. The last update date is 2011-11-09.
Kimbo Medical Distributor's current location address is 407 N Avalon Blvd, Wilmington, California. You can contact this provider via phone number 3108349574 and fax number 8663985898. The mailing address for Kimbo Medical Distributor is 407 N Avalon Blvd, Wilmington, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Kimbo Medical Distributor |
|---|---|
| Address | 407 N Avalon Blvd, Wilmington, California |
| Phone Number | 3108349574 |
| Fax Number | 8663985898 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | C.E.O |
|---|---|
| Authorized Official Name | Tamunang Tabe Godwill |
| Credentials | P.T |
| Telephone Number | 3108349574 |
NPI Number Detail
| NPI Number | 1891916367 |
|---|---|
| Provider Enumeration Date | 2007-05-01 |
| Last Updated Date | 2011-11-09 |
Provider Mailing Address Detail
| Address | 407 N Avalon Blvd |
|---|---|
| City | Wilmington |
| State | California (CA) |
| Post Code | 907445803 |
| Phone Number | 3108349574 |
| Fax Number | 8663985898 |
Provider's Primary Taxonomy Detail
| Speciality | Parenteral & Enteral Nutrition |
|---|---|
| Taxonomy | 332Bp3500X |
| Licence No | 44548 |
|
Definition: Durable medical equipment and supplies for tube feeding and intravenous nutritional support prescribed by providers. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| CMCSUBT9E | CA | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Kimbo Medical Distributor?
The Kimbo Medical Distributor has been issued the NPI (National Provider Identifier) 1891916367 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete physical address where Kimbo Medical Distributor is located?
The Kimbo Medical Distributor is situated at the following address: 407 N Avalon Blvd, Wilmington, CA, 907445803.
What is Kimbo Medical Distributor's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Kimbo Medical Distributor is Parenteral & Enteral Nutrition, and the corresponding taxonomy classification code for this specialized field is 332Bp3500X.
On what date did the Kimbo Medical Distributor receive the assignment of its 1891916367 from the Centers for Medicare & Medicaid Services?
The Kimbo Medical Distributor was issued its 1891916367 by the Centers for Medicare & Medicaid Services on 2007-05-01.
When was the information related to Kimbo Medical Distributor most recently updated or refreshed?
The details pertaining to the Kimbo Medical Distributor, including its address, specialty, and other relevant information, were last updated or refreshed on 2011-11-09.