Organization Name: | KIDD HEALTHMART DRUG CO |
NPI Number: | 1295880185 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN KIDD MARTENS (PRESIDENT) |
Mailing Address: | 104 N Main St Fairview |
State: | OK US |
Postal Code: | 737371621 |
Phone Number: | 5802274685 |
Fax Number: | 5802272351 |
NPI Enumeration Date: | 01/24/2007 |
NPI Last Update Date: | 11/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
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 |