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General NPI Number Information
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NPI Number | 1700572153
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Entity Type | Organization
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Legal Business Name | WIGSLAYERS
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Dates
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Enumeration Date | 04/17/2023
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 2520 S 90TH DR
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City | TOLLESON
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State | AZ
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Zip | 85353-6928
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Country | US
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Telephone | 480-356-2118
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 511
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City | TOLLESON
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State | AZ
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Zip | 85353-0511
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Country | US
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Telephone | 480-356-2118
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHALALAH N SAUNDERS
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Credential |
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Telephone | 480-356-2118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #3
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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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