Provider Demographics
NPI:1235362823
Name:WILMINGTON ISLAND DME, INC
Entity Type:Organization
Organization Name:WILMINGTON ISLAND DME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:C
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-854-9363
Mailing Address - Street 1:1890 W BAY DR
Mailing Address - Street 2:SUITE W-4
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-3019
Mailing Address - Country:US
Mailing Address - Phone:877-854-9363
Mailing Address - Fax:877-854-9362
Practice Address - Street 1:1890 W BAY DR
Practice Address - Street 2:SUITE W-4
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3019
Practice Address - Country:US
Practice Address - Phone:877-854-9363
Practice Address - Fax:877-854-9362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-28
Last Update Date:2019-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6361560001Medicare NSC