Provider Demographics
NPI:1912093279
Name:KOZIKS HOME MEDICAL EQUIPMENT CENTER INC
Entity type:Organization
Organization Name:KOZIKS HOME MEDICAL EQUIPMENT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:KOZIK
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:610-444-2240
Mailing Address - Street 1:305 WEST STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3052
Mailing Address - Country:US
Mailing Address - Phone:610-444-2240
Mailing Address - Fax:610-444-9098
Practice Address - Street 1:305 W STATE ST
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-3052
Practice Address - Country:US
Practice Address - Phone:610-444-2240
Practice Address - Fax:610-444-9098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3000007903332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015696530001Medicaid
PA1015696530001Medicaid