# WNC MEDICAL SUPPLY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417126780
- **Authorized official:** MS. LOLITA LYDIA SHARP (OWNER)
- **Authorized official phone:** (408) 335-8744

## Contact information

- **Practice address:** 3705 BEACON AVE STE 200, FREMONT, CA 94538-1467
- **Practice address phone:** (510) 796-5555
- **Practice address fax:** (510) 796-7044
- **Mailing address:** 3705 BEACON AVE STE 200, FREMONT, CA 94538-1467
- **Mailing address phone:** (510) 796-5555
- **Mailing address fax:** (510) 796-7044

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | — |

## Other

- **Enumeration date:** 02/20/2008
- **Last updated:** 02/20/2008