Organization
WALLA WALLA HOMEMEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY BUCKLEY (GENERAL MANAGER)
(509) 525-1066
Entity
Organization
Contact information
Practice address
329 S 2ND AVE, WALLA WALLA, WA 99362-3034
(509) 525-1066
(509) 522-2361
Mailing address
329 S 2ND AVE, WALLA WALLA, WA 99362-3034
(509) 525-1066
(509) 522-2361
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
601013167
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161646
—
OR
05
—
9001710
—
WA
05
—
9012832
—
WA
Enumeration date
05/24/2005
Last updated
12/21/2012
Update your record
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