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General NPI Number Information
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NPI Number | 1093803769
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Entity Type | Organization
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Legal Business Name | PHILOMINA O WALKER-NWARUEZE
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 1430 E COOLEY DR SUITE 200
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City | COLTON
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State | CA
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Zip | 92324-3934
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Country | US
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Telephone | 909-433-0574
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Fax | 909-433-0519
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Provider Business Mailing Address
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Address Line | 1430 E COOLEY DR SUITE 200
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City | COLTON
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State | CA
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Zip | 92324-3934
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Country | US
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Telephone | 909-433-0574
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Fax | 909-433-0519
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. PHILOMINA OGOCHUKWU WALKER-NWARUEZE
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Credential | MBA
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Telephone | 909-899-3135
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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 | 45953
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License Number State | CA
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