Provider Demographics
NPI:1649848672
Name:KOYA MEDICAL, INC.
Entity type:Organization
Organization Name:KOYA MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAMIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIPPOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-234-3895
Mailing Address - Street 1:PO BOX 6919
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97228-6919
Mailing Address - Country:US
Mailing Address - Phone:833-999-5692
Mailing Address - Fax:855-461-3339
Practice Address - Street 1:2332 VALDINA ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-6108
Practice Address - Country:US
Practice Address - Phone:833-999-5692
Practice Address - Fax:855-461-3339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-16
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies