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General NPI Number Information
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NPI Number | 1285749622
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Entity Type | Organization
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Legal Business Name | WICHITA HOME CARE EQUIPMENT, INC.
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 06/28/2012
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Provider Practice Location Address
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Address Line | 5046 COMMERCIAL CIR STE G
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City | CONCORD
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State | CA
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Zip | 94520-8573
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Country | US
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Telephone | 925-680-0638
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Fax |
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Provider Business Mailing Address
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Address Line | 5046 COMMERCIAL CIR STE G
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City | CONCORD
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State | CA
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Zip | 94520-8573
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Country | US
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Telephone | 925-680-0638
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CLIFF WOOLARD
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Credential |
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Telephone | 925-680-0638
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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 | 100048
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License Number State | CA
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