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NPI 1710985718

NPI 1710985718 : WOLF INDUSTRIES INC : LONG BEACH, MS

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General NPI Number Information
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    NPI Number           |    1710985718
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    Entity Type          |    Organization 
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    Legal Business Name  |    WOLF INDUSTRIES INC 
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Dates
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    Enumeration Date     |    07/13/2005
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    Last Update Date     |    10/13/2025
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Provider Practice Location Address
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    Address Line         |    6003 DAUGHERTY RD 
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    City                 |    LONG BEACH
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    State                |    MS
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    Zip                  |    39560-2654
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    Country              |    US
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    Telephone            |    228-863-3331
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    Fax                  |    228-863-3392
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Provider Business Mailing Address
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    Address Line         |    555 E NORTH LN STE 5075 
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    City                 |    CONSHOHOCKEN
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    State                |    PA
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    Zip                  |    19428-2490
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CCO
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    Name                 |     WENDY  RUSSALESI 
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    Credential           |    
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    Telephone            |    484-246-9499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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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Taxonomy #3
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    Taxonomy Code        |    332BX2000X
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    Taxonomy Name        |    Oxygen Equipment & Supplies (DME)
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    License Number       |    
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    License Number State |    
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