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General NPI Number Information
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NPI Number | 1073932190
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Entity Type | Organization
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Legal Business Name | DELMARVA WIGS AND THINGS LLC
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Dates
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Enumeration Date | 04/16/2014
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Last Update Date | 01/16/2015
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Provider Practice Location Address
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Address Line | 720 E COLLEGE AVE STE D
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City | SALISBURY
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State | MD
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Zip | 21804-6657
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Country | US
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Telephone | 410-742-0100
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Fax | 410-742-0104
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Provider Business Mailing Address
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Address Line | 720 E COLLEGE AVE STE D
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City | SALISBURY
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State | MD
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Zip | 21804-6657
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Country | US
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Telephone | 410-742-0100
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Fax | 410-742-0104
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | KIMBERLY ANNE JACKSON
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Credential | C.M.F.
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Telephone | 410-742-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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