Provider Demographics
NPI:1023556602
Name:MERRY WALKER CORPORATION
Entity Type:Organization
Organization Name:MERRY WALKER CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARROUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-837-9580
Mailing Address - Street 1:21350 WEST SYLVAN DRIVE SOUTH
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060
Mailing Address - Country:US
Mailing Address - Phone:847-837-9580
Mailing Address - Fax:847-837-9582
Practice Address - Street 1:21350 WEST SYLVAN DRIVE SOUTH
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060
Practice Address - Country:US
Practice Address - Phone:847-837-9580
Practice Address - Fax:847-837-9582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
059365000001OtherMPN OLD