Organization
WEST SIDE MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN GOODEN MD (OWNER)
(316) 636-7900
Entity
Organization
Contact information
Practice address
602 N WEBB RD STE 108, WICHITA, KS 67206-1803
(316) 636-7900
(316) 636-7939
Mailing address
602 N WEBB RD STE 108, WICHITA, KS 67206-1803
(316) 636-7900
(316) 636-7939
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
11/09/2011
Last updated
11/08/2019
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