Organization Name: | COMPLETE FAMILY MEDICINE LLC |
NPI Number: | 1154557403 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JUSTIN DAVID PUCKETT (MANAGER) |
Mailing Address: | 1611 S Baltimore St Kirksville |
State: | MO US |
Postal Code: | 635014536 |
Phone Number: | 6606657575 |
Fax Number: | 6606657576 |
NPI Enumeration Date: | 06/01/2009 |
NPI Last Update Date: | 01/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 6683320001 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |