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Organization

VALLEY MEDICAL SUPPLY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. GLENNA G. EDWARDS CERTIFIED FITTER (OWNER / FITTER)
(907) 373-1014
Entity
Organization

Contact information

Practice address
546 N MAIN ST, WASILLA, AK 99654-7019
(907) 373-1014
(907) 357-1424
Mailing address
546 N MAIN ST, WASILLA, AK 99654-7019
(907) 373-1014
(907) 357-1424

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
200280
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MS2280
AK
05
PO2280
AK
Enumeration date
10/02/2006
Last updated
08/04/2008
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