Organization
MONROE WHEELCHAIR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS WESTERDAHL (PRESIDENT)
(585) 385-3920
Entity
Organization
Contact information
Practice address
388 OLD NISKAYUNA RD, LATHAM, NY 12110-2212
(518) 783-1653
(518) 783-6305
Mailing address
2165 BRIGHTON HENRIETTA TOWN LINE RD, SUITE 1, ROCHESTER, NY 14623-2755
(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
01
—
00011191701
UNIVERA
—
01
—
000551000003
HEALTHNOW
NY
05
—
02414744
—
NY
01
—
040401000140
FIDELIS CARE
—
01
—
10049384-8085
CDPHP
—
01
—
25177
DMENSION BENEFIT MGMT
—
01
—
7183753
AETNA
NY
01
—
888335
MVP HEALTH PLAN
NY
01
—
9660309
GHI
—
01
—
MB
BLUE CROSS FEDERAL
—
Enumeration date
05/16/2006
Last updated
10/19/2015
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