Provider Demographics
NPI:1376991075
Name:WALKER HOME MEDICAL INC
Entity Type:Organization
Organization Name:WALKER HOME MEDICAL INC
Other - Org Name:WALKER HOME MEDICAL - MARKET DISTRICT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROSWELL
Authorized Official - Middle Name:LINDSAY
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-681-3838
Mailing Address - Street 1:PO BOX 2088
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30459
Mailing Address - Country:US
Mailing Address - Phone:912-681-3838
Mailing Address - Fax:912-681-3839
Practice Address - Street 1:1198 MERCHANT WAY
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-0883
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:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2016001928332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies