Provider Demographics
NPI:1922325596
Name:3 KB S ENTERPRISE INC CORPORATION
Entity type:Organization
Organization Name:3 KB S ENTERPRISE INC CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BUENCONSEJO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:260-489-9533
Mailing Address - Street 1:2870 E DUPONT RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-1669
Mailing Address - Country:US
Mailing Address - Phone:260-489-9533
Mailing Address - Fax:260-497-9088
Practice Address - Street 1:2870 E DUPONT RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1669
Practice Address - Country:US
Practice Address - Phone:260-489-9533
Practice Address - Fax:260-497-9088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-22
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies