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General NPI Number Information
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NPI Number | 1740177328
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Entity Type | Organization
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Legal Business Name | MED WAY MEDICAL, INC
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 5929 FASHION POINT DR STE 103
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City | SOUTH OGDEN
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State | UT
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Zip | 84403-4683
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Country | US
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Telephone | 801-566-0567
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Fax |
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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 | 19428-2233
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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 | CHIEF COMPLIANCE OFFICER
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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 | 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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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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