Organization
MONROE WHEELCHAIR OF THE SOUTHERN TIER REGION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS WESTERDAHL (PRESIDENT)
(585) 385-3920
Entity
Organization
Contact information
Practice address
217 MAIN ST, BINGHAMTON, NY 13905-2627
(607) 729-8244
(607) 729-8248
Mailing address
3340 MONROE AVE, ROCHESTER, NY 14618-4612
(585) 385-3920
(585) 385-6966
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02441587
—
NY
Enumeration date
05/18/2006
Last updated
08/22/2020
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