Provider Demographics
NPI:1437314754
Name:WORMILL INC.
Entity Type:Organization
Organization Name:WORMILL INC.
Other - Org Name:THE VAN HOUSE MOBILITY PRODUCTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:WORNOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-851-8000
Mailing Address - Street 1:PO BOX 4055
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23664-0055
Mailing Address - Country:US
Mailing Address - Phone:757-851-8000
Mailing Address - Fax:757-850-3653
Practice Address - Street 1:2002 E PEMBROKE AVE
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23664-1111
Practice Address - Country:US
Practice Address - Phone:757-851-8000
Practice Address - Fax:757-850-3653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA87102332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment