Provider Demographics
NPI:1154326189
Name:KING HOME MEDICAL EQUIPMENT INC
Entity type:Organization
Organization Name:KING HOME MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-966-2000
Mailing Address - Street 1:1950 COLUMBIA AVE W
Mailing Address - Street 2:STE A
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-2891
Mailing Address - Country:US
Mailing Address - Phone:269-966-2000
Mailing Address - Fax:269-966-9019
Practice Address - Street 1:1950 COLUMBIA AVE W
Practice Address - Street 2:STE A
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-2891
Practice Address - Country:US
Practice Address - Phone:269-966-2000
Practice Address - Fax:269-966-9019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI82-32050OtherPHYSICIANS HEALTH PLAN
MIP59370OtherBLUE CARE NETWORK
MI3279570Medicaid
PA1413106OtherBCBS OF PA
MI121437OtherGREAT LAKES HEALTH PLAN
MI=========050OtherCOMMUNITY CHOICE MICHIGAN
MI3279570Medicaid