| Organization Name: | KAVANAUGH SUPPLIES LLC |
| NPI Number: | 1942221973 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN KAVANAUGH (MANAGING MEMBER) |
| Mailing Address: | 22 98 Place Blvd Suite 10 Hattiesburg |
| State: | MS US |
| Postal Code: | 394028603 |
| Phone Number: | 6012966763 |
| Fax Number: | 6012966764 |
| NPI Enumeration Date: | 07/23/2006 |
| NPI Last Update Date: | 06/08/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 037068103 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| 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 |