Provider Demographics
NPI:1295858736
Name:WMK, LLC
Entity Type:Organization
Organization Name:WMK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCKINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:234-200-1379
Mailing Address - Street 1:4199 KINROSS LAKES PKWY
Mailing Address - Street 2:SUITE 300, ATTN: ANNMARIE BUCKINGHAM
Mailing Address - City:RICHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44286-9010
Mailing Address - Country:US
Mailing Address - Phone:234-200-1379
Mailing Address - Fax:330-659-0876
Practice Address - Street 1:810 MOE DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-2517
Practice Address - Country:US
Practice Address - Phone:330-633-1118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171WH0202X, 171WV0202X, 332B00000X, 332BC3200X, 347C00000X
OHRE000034171WV0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WV0202XOther Service ProvidersContractorVehicle ModificationsGroup - Multi-Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103424092Medicaid
OH2084775Medicaid
IN300082172Medicaid
OH7718871Medicaid
TX3749376Medicaid
NE47737414Medicaid
IA1295858736Medicaid
DE250589236Medicaid