Healthcare Provider Details

I. General information

NPI: 1619107497
Provider Name (Legal Business Name): WILNICK SURGICAL SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 07/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3408 SHOREWOOD CT
ARLINGTON TX
76016-2646
US

IV. Provider business mailing address

PO BOX 14438
ARLINGTON TX
76094-1438
US

V. Phone/Fax

Practice location:
  • Phone: 972-668-7460
  • Fax: 972-668-7467
Mailing address:
  • Phone: 972-668-7460
  • Fax: 972-668-7467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: JOEL SINGLETON
Title or Position: OWNER
Credential:
Phone: 972-668-7460