Provider Demographics
NPI:1063613115
Name:K A G DESIGN
Entity type:Organization
Organization Name:K A G DESIGN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT SECRETARY TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:GALASKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-671-4704
Mailing Address - Street 1:6805 MAYFIELD RD
Mailing Address - Street 2:#613A
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124
Mailing Address - Country:US
Mailing Address - Phone:330-671-4704
Mailing Address - Fax:
Practice Address - Street 1:6805 MAYFIELD RD
Practice Address - Street 2:#613A
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124
Practice Address - Country:US
Practice Address - Phone:330-671-4704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies