Provider Demographics
NPI:1487169991
Name:KS MEDICAL SOLUTIONS, INC
Entity type:Organization
Organization Name:KS MEDICAL SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-560-2353
Mailing Address - Street 1:19455 GULF BLVD STE 8
Mailing Address - Street 2:
Mailing Address - City:INDIAN SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33785-2000
Mailing Address - Country:US
Mailing Address - Phone:727-509-3050
Mailing Address - Fax:727-509-3051
Practice Address - Street 1:19455 GULF BLVD STE 8
Practice Address - Street 2:
Practice Address - City:INDIAN SHORES
Practice Address - State:FL
Practice Address - Zip Code:33785-2000
Practice Address - Country:US
Practice Address - Phone:727-509-3050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-06
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
FL7663930001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies