Provider Demographics
NPI:1316126931
Name:KATHLEEN E. HUGGINS
Entity type:Organization
Organization Name:KATHLEEN E. HUGGINS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HUGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:805-550-9120
Mailing Address - Street 1:2705 MCMILLAN AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-4741
Mailing Address - Country:US
Mailing Address - Phone:805-541-1463
Mailing Address - Fax:805-541-1469
Practice Address - Street 1:2705 MCMILLAN AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4741
Practice Address - Country:US
Practice Address - Phone:805-541-1463
Practice Address - Fax:805-541-1469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DME01775GOtherMEDICAL