Organization
WALL HOME MEDICAL EQUIPMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BARBARA M WALL RRPT (OWNER)
(843) 374-2299
Entity
Organization
Contact information
Practice address
221 RODGERS AVE, LAKE CITY, SC 29560-2151
(843) 374-2299
(843) 374-2932
Mailing address
221 RODGERS AVE, LAKE CITY, SC 29560-2151
(843) 374-2299
(843) 374-2932
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
021168816
SC
335E00000X
Prosthetic/Orthotic Supplier
021168816
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20039999
—
SC
05
—
558765
—
SC
Enumeration date
04/24/2006
Last updated
06/25/2008
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