Organization
WALLACE HOME MEDICAL SUPPLIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRAGO WALLACE ATS (PRESIDENT)
(805) 238-3935
Entity
Organization
Contact information
Practice address
549 10TH ST, PASO ROBLES, CA 93446-2510
(805) 238-3935
Mailing address
549 10TH ST, PASO ROBLES, CA 93446-2510
(805) 238-3935
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME03195F
—
CA
01
—
ZZZ 08974 Z
BLUE SHIELD
CA
Enumeration date
06/30/2008
Last updated
06/17/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us