Organization
WINDHAM MEDICAL SUPPLIES
Active
Other names
Matt Windham Jr
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT WINDHAM JR. (OWNER)
(773) 288-2844
Entity
Organization
Contact information
Practice address
2056 EAST 71ST STREET, CHICAGO, IL 60649-2117
(773) 288-2844
(773) 288-2848
Mailing address
2056 EAST 71ST STREET, CHICAGO, IL 60649-2117
(773) 288-2844
(773) 288-2848
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RFP797FSS990025R4
VA NATIONAL ACQUICITION C
—
Enumeration date
11/20/2006
Last updated
03/28/2008
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