Provider Demographics
NPI:1093803769
Name:PHILOMINA O WALKER-NWARUEZE
Entity Type:Organization
Organization Name:PHILOMINA O WALKER-NWARUEZE
Other - Org Name:PHILOMINA MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHILOMINA
Authorized Official - Middle Name:OGOCHUKWU
Authorized Official - Last Name:WALKER-NWARUEZE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:909-899-3135
Mailing Address - Street 1:1430 E COOLEY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-3934
Mailing Address - Country:US
Mailing Address - Phone:909-433-0574
Mailing Address - Fax:909-433-0519
Practice Address - Street 1:1430 E COOLEY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-3934
Practice Address - Country:US
Practice Address - Phone:909-433-0574
Practice Address - Fax:909-433-0519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45953332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5808300001Medicare NSC