Organization
GE WIESE DBA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH EDWARD WIESE (GENERAL MANAGER)
(830) 768-1818
Entity
Organization
Contact information
Practice address
714 N BEDELL AVE, DEL RIO, TX 78840-4111
(830) 768-1818
(830) 778-8618
Mailing address
714 N BEDELL AVE, DEL RIO, TX 78840-4111
(830) 768-1818
(830) 778-8618
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
06/11/2006
Last updated
09/11/2025
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