Organization
BWDC MEDICAL EQUIPMENT CO.
Active
Other names
Byrd Watson Medical Equip Co
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WESLEY N BREEZE RPH (OWNER PRES)
(618) 532-3045
Entity
Organization
Contact information
Practice address
123 N LOCUST ST, CENTRALIA, IL 62801-5303
(618) 532-3045
(618) 533-0572
Mailing address
123 N LOCUST ST, PO BOX 1747, CENTRALIA, IL 62801-3242
(618) 532-3045
(618) 533-0572
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
203000105
IL
Other
Enumeration date
10/25/2005
Last updated
05/21/2012
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