Provider Demographics
NPI:1235226556
Name:WALKER HOME MEDICAL INC
Entity Type:Organization
Organization Name:WALKER HOME MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSWELL
Authorized Official - Middle Name:LINDSAY
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-764-6175
Mailing Address - Street 1:PO BOX 2088
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30459-2088
Mailing Address - Country:US
Mailing Address - Phone:912-681-3838
Mailing Address - Fax:912-681-3839
Practice Address - Street 1:2467 NORTHSIDE DR W
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-2153
Practice Address - Country:US
Practice Address - Phone:912-681-3838
Practice Address - Fax:912-681-3839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000286899BMedicaid
GA6056850002Medicare NSC
GA0310930001Medicare NSC