| Organization Name: | KCJE FORD INC |
| NPI Number: | 1578587606 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENNETH FORD (OWNER) |
| Mailing Address: | 528 Cass St La Crosse |
| State: | WI US |
| Postal Code: | 546014507 |
| Phone Number: | 6087849922 |
| Fax Number: | 6087842212 |
| NPI Enumeration Date: | 07/26/2006 |
| NPI Last Update Date: | 05/10/2016 |
| 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 |