Provider Demographics
NPI:1447310099
Name:KINETIC HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:KINETIC HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MULVIHILL
Authorized Official - Suffix:JR
Authorized Official - Credentials:AT,C
Authorized Official - Phone:703-622-9032
Mailing Address - Street 1:1125 WEST STREET
Mailing Address - Street 2:SUITE 304
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-4198
Mailing Address - Country:US
Mailing Address - Phone:703-622-9032
Mailing Address - Fax:800-936-3359
Practice Address - Street 1:1125 WEST STREET
Practice Address - Street 2:SUITE 304
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4198
Practice Address - Country:US
Practice Address - Phone:703-622-9032
Practice Address - Fax:800-936-3359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART-001446-A2255A2300X
MD02171211332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies