Provider Demographics
NPI:1851508402
Name:WHARTON MEDICAL EQUIPMENT & ACCESSORIES LLC
Entity Type:Organization
Organization Name:WHARTON MEDICAL EQUIPMENT & ACCESSORIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:I
Authorized Official - Last Name:MACLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-532-3334
Mailing Address - Street 1:142 W MILAM ST
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:TX
Mailing Address - Zip Code:77488-5026
Mailing Address - Country:US
Mailing Address - Phone:979-532-3334
Mailing Address - Fax:979-532-4466
Practice Address - Street 1:142 W MILAM ST
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:TX
Practice Address - Zip Code:77488-5026
Practice Address - Country:US
Practice Address - Phone:979-532-3334
Practice Address - Fax:979-532-4466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0081363332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5440670001Medicare NSC