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General NPI Number Information
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NPI Number | 1376991075
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Entity Type | Organization
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Legal Business Name | WALKER HOME MEDICAL INC
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Dates
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Enumeration Date | 06/03/2016
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Last Update Date | 06/03/2016
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Provider Practice Location Address
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Address Line | 1198 MERCHANT WAY
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City | STATESBORO
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State | GA
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Zip | 30458-0883
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Country | US
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Telephone | 912-681-3838
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Fax | 912-681-3839
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Provider Business Mailing Address
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Address Line | PO BOX 2088
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City | STATESBORO
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State | GA
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Zip | 30459
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Country | US
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Telephone | 912-681-3838
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Fax | 912-681-3839
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROSWELL LINDSAY WALKER
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Credential |
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Telephone | 912-681-3838
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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 | 2016001928
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License Number State | GA
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