MEDICARE: W-T SERVICES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	332B00000X	IL

General Provider Information

NPI Number	:	1710342738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	W-T SERVICES INC.

Provider Business Mailing Address
First Line	:	1922 OHIO AVE
Second Line	:
City	:	EAST SAINT LOUIS
State	:	IL
Zip	:	62205-1807
Country	:	US
Telephone Number	:	618-671-2515
Fax Number	:	618-215-0908

Provider Business Practice Location Address
First Line	:	1922 OHIO AVE
Second Line	:
City	:	EAST SAINT LOUIS
State	:	IL
Zip	:	62205-1807
Country	:	US
Telephone Number	:	618-671-2515
Fax Number	:	618-215-0908

Authorized Official
Title or Position	:	C.E.O.
Name	:	MS. ANGELA MONTRESE DEW
Credential	:	OWNER
Telephone Number	:	618-671-2515

Provider Enumeration Date	:	12/17/2015
Last Update Date	:	01/06/2016

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