MEDICARE: WALNUT MANAGEMENT CORP

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)	3000008872	PA

General Provider Information

NPI Number	:	1811253438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALNUT MANAGEMENT CORP

Provider Business Mailing Address
First Line	:	226 MAIN ST.
Second Line	:
City	:	JOHNSTOWN
State	:	PA
Zip	:	15901-1509
Country	:	US
Telephone Number	:	814-533-0901
Fax Number	:	814-533-0196

Provider Business Practice Location Address
First Line	:	1228 WAYNE AVE
Second Line	:
City	:	INDIANA
State	:	PA
Zip	:	15701-3514
Country	:	US
Telephone Number	:	724-463-4500
Fax Number	:	724-463-4505

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. JOHN W REED
Credential	:
Telephone Number	:	814-533-0901

Provider Enumeration Date	:	04/09/2012
Last Update Date	:	03/11/2016

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Directions to “WALNUT MANAGEMENT CORP ” Practice Location

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