MEDICARE: WALTCO MEDICAL EQUIPMENT & SUPPLIES,INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	0067012	TX

General Provider Information

NPI Number	:	1730280876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALTCO MEDICAL EQUIPMENT & SUPPLIES,INC.

Provider Business Mailing Address
First Line	:	1200 E DAVIS ST
Second Line	:	SUITE 113
City	:	MESQUITE
State	:	TX
Zip	:	75149-8729
Country	:	US
Telephone Number	:	972-290-9033
Fax Number	:	972-288-9947

Provider Business Practice Location Address
First Line	:	1200 E DAVIS ST
Second Line	:	SUITE 113
City	:	MESQUITE
State	:	TX
Zip	:	75149-8729
Country	:	US
Telephone Number	:	972-290-9033
Fax Number	:	972-288-9947

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. WALTER LOUIS SANDERS
Credential	:
Telephone Number	:	972-290-9033

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	08/22/2020

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Directions to “WALTCO MEDICAL EQUIPMENT & SUPPLIES,INC. ” Practice Location

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