Provider Demographics
NPI:1568445252
Name:EMWOOD CORPORATION
Entity Type:Organization
Organization Name:EMWOOD CORPORATION
Other - Org Name:WOOD MEDICAL SUPPLY-SAN ANTONIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MILBERN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-492-5535
Mailing Address - Street 1:16147 COLLEGE OAK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-4011
Mailing Address - Country:US
Mailing Address - Phone:210-492-5533
Mailing Address - Fax:210-492-5535
Practice Address - Street 1:16147 COLLEGE OAK
Practice Address - Street 2:103
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-4011
Practice Address - Country:US
Practice Address - Phone:210-492-5533
Practice Address - Fax:210-492-5535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-28
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0012362332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0964800001Medicare ID - Type Unspecified