Organization Name: | ETERNAL KINGDOM ENTERPRISES INC. |
NPI Number: | 1003930603 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL D BOLLING (PRESIDENT) |
Mailing Address: | 519 N Beard St Shawnee |
State: | OK US |
Postal Code: | 748016729 |
Phone Number: | 4052737638 |
Fax Number: | 4052730037 |
NPI Enumeration Date: | 03/19/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171WH0202X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | Home Modifications |
Taxonomy Definition: |