Provider Demographics
NPI:1891580767
Name:MK SUPPLIES INC
Entity type:Organization
Organization Name:MK SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KASHMIERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-217-3086
Mailing Address - Street 1:8415B TERMINAL RD
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-1425
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8415B TERMINAL RD
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-1425
Practice Address - Country:US
Practice Address - Phone:703-217-3086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies