Organization
POWER WHEELS MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY E DEVINE (MANAGER)
(323) 459-3047
Entity
Organization
Contact information
Practice address
1647 W AVENUE J STE 105, LANCASTER, CA 93534-2881
(661) 471-9081
Mailing address
1647 W AVENUE J STE 105, LANCASTER, CA 93534-2881
(661) 471-9081
Taxonomy
Speciality
Code
Description
License number
State
171WV0202X
Vehicle Modifications Contractor
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/08/2023
Last updated
11/20/2023
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