Provider Demographics
NPI:1346225133
Name:WESTERN HEALTH RESOURCES
Entity Type:Organization
Organization Name:WESTERN HEALTH RESOURCES
Other - Org Name:ADVENTIST HEALTH HOME MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:WIEDEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:916-781-4772
Mailing Address - Street 1:2100 DOUGLAS BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3804
Mailing Address - Country:US
Mailing Address - Phone:916-781-4771
Mailing Address - Fax:916-774-3341
Practice Address - Street 1:280 TROUSDALE DR
Practice Address - Street 2:SUITE #A
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-1079
Practice Address - Country:US
Practice Address - Phone:619-426-4662
Practice Address - Fax:619-426-4362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA437980Medicaid
CA0424850001Medicare NSC