Provider Demographics
NPI:1366168064
Name:MEGA MEDICAL SUPPLY LLC
Entity type:Organization
Organization Name:MEGA MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:EKIKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-400-8979
Mailing Address - Street 1:1450 S HAVANA ST STE 600
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4032
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1450 S HAVANA ST STE 600
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4032
Practice Address - Country:US
Practice Address - Phone:720-400-8979
Practice Address - Fax:720-800-4466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies