Organization
A&W HOME MEDICAL EQUIPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER L JOHNSON (CEO)
(313) 837-0100
Entity
Organization
Contact information
Practice address
1416 PINSON ST, BIRMINGHAM, AL 35217-2505
(313) 837-0100
(313) 837-3323
Mailing address
1416 PINSON ST, BIRMINGHAM, AL 35217-2505
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2840199
MEDICAID
MI
Enumeration date
11/13/2006
Last updated
08/22/2020
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