Provider Demographics
NPI:1124902150
Name:K&P DME SUPPLIES
Entity type:Organization
Organization Name:K&P DME SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KYLLE
Authorized Official - Middle Name:XAVIER
Authorized Official - Last Name:PAYNE-WERLITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-395-9817
Mailing Address - Street 1:3548 TIMBER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-0260
Mailing Address - Country:US
Mailing Address - Phone:540-395-9817
Mailing Address - Fax:
Practice Address - Street 1:3548 TIMBER RIDGE DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-9413
Practice Address - Country:US
Practice Address - Phone:540-395-9817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies