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General NPI Number Information
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NPI Number | 1942380068
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Entity Type | Organization
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Legal Business Name | WESTLAKE MEDICAL EQUIPMENT, LLC
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13455 BOOKER T WASHINGTON HWY SUITE 101
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City | MONETA
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State | VA
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Zip | 24121-6150
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Country | US
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Telephone | 540-721-9013
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Fax | 540-721-9083
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Provider Business Mailing Address
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Address Line | 13455 BOOKER T WASHINGTON HWY SUITE 101
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City | MONETA
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State | VA
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Zip | 24121-6150
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Country | US
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Telephone | 540-721-9013
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Fax | 540-721-9083
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Authorized Official
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Title or Position | OWNER
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Name | MR. ADAM OWEN
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Credential |
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Telephone | 540-721-9013
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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 | 0206009233
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License Number State | VA
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