KOUCH MEDICAL LLC (NPI# 1306932736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306932736 |
| Entity Type | Organization |
| Organization Name | KOUCH MEDICAL LLC |
| Practice Address |
1325 Travis Blvd Ste B Fairfield CA 94533-4611 |
| Practice Telephone | 7074218145 |
| Practice Fax Number | 7074218155 |
| Mailing Telephone | 7074218145 |
| Mailing Fax Number | 7074218155 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. CHIBUIKEM IHEANACHO (PRESIDENT) |
| Authorized Official Telephone | 7074211845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Street Address |
1325 TRAVIS BLVD STE B |
| City | FAIRFIELD |
| State | CA |
| Zip Code | 94533-4611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043693153 | Alison Woon Lin Lee | Registered Nurse | 1325 Travis Blvd, Suite C, Fairfield, CA 94533-4611 | 2015-07-07 |
| 1720133796 | Parkside Dental Care | Dentist | 1325 Travis Blvd, Fairfield, CA 94533-4611 | 2007-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609487347 | Shayondelice Sledge | Case Manager/Care Coordinator | 3001 N. Texas St., #27, Fairfield, CA 94533 | 2020-08-16 |
| 1508401191 | Tiffany Ann Garcia | Social Worker | 1301 Roman Way, Martinez, CA 94533 | 2019-11-07 |
| 1609424175 | Andrew Stephens | Student in an Organized Health Care Education/Training Program | Dgmc, 101 Bodin Cir, Fairfield, CA 94533 | 2019-08-28 |
| 1821645383 | Michelle Marie Hackett | Marriage & Family Therapist | 1745 Enterprise Dr., Bldg. 2, Ste 1a, Fairfield, CA 94533 | 2019-08-20 |
| 1780154369 | Maria Leonila Ramos Corpuz | Behavior Technician | 744 Empire Street Suite 160, Fairfield, CA 94533 | 2018-11-27 |
| 1629575303 | Jeanne Ann Kiernan | Dentist | 690 Airman Dr, Apo, AA 94533 | 2018-04-10 |
| 1629596820 | Max Kardos | Student in an Organized Health Care Education/Training Program | 801 Empire St., Fairfield, CA 94533 | 2017-09-07 |
| 1780119867 | Justin Denhart Dickson | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir Fairfield Ca 94533, David Grant Medical Center, Fpo, AA 94533 | 2017-04-26 |
| 1639613409 | Behrooz Shafiezadeh | Marriage & Family Therapist | Caminar, 601 Madison Street, Suite D, Fairfield, CA 94533 | 2016-12-13 |
| 1427500164 | Tanya Ayers | Counselor | 801 Empire Street, Fairfield, CA 94533 | 2016-10-28 |
| Find all providers in zip 94533 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033678438 | Smart Choice Medical LLC | Durable Medical Equipment & Medical Supplies | 1305 Post Rd Ste 205, Fairfield, CT 06824-6016 | 2019-03-15 |
| 1851816482 | Aperion Care Fairfield LLC | Durable Medical Equipment & Medical Supplies | 305 Nw 11th St, Fairfield, IL 62837-1203 | 2017-08-04 |
| 1073963468 | Supercare, Inc. | Durable Medical Equipment & Medical Supplies | 505 Watt Dr, Suite 3, Fairfield, CA 94534-1791 | 2016-06-15 |
| 1174924484 | Harriet Stricklen | Durable Medical Equipment & Medical Supplies | 3345 Spyglass Ct, Fairfield, CA 94534-8310 | 2014-09-07 |
| 1346687456 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2590 N Texas St, Fairfield, CA 94533-1606 | 2013-05-30 |
| 1477899011 | Criticare Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 277 Fairfield Rd Ste 102d, Fairfield, NJ 07004-1931 | 2013-01-01 |
| 1508139106 | Diabetic Headquarters Inc. | Durable Medical Equipment & Medical Supplies | 8695 Seward Road, Fairfield, OH 45011-9716 | 2012-02-14 |
| 1154617215 | Senior Care Pharmacy Services Fairfield Inc | Durable Medical Equipment & Medical Supplies | 4950 Fulton Dr, Suite A and B, Fairfield, CA 94534-1615 | 2011-06-27 |
| 1497045892 | Connecticut Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 330 Grasmere Avenue, Fairfield, CT 06824 | 2011-04-19 |
| 1033346127 | Madison County Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 1401 S Main St Ste 101, Fairfield, IA 52556 | 2009-06-16 |
| Find all providers in FAIRFIELD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.