Provider Demographics
NPI:1891970539
Name:WALKER HOME MEDICAL INC.
Entity Type:Organization
Organization Name:WALKER HOME MEDICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-353-1809
Mailing Address - Street 1:1100 EISENHOWER DR
Mailing Address - Street 2:STE 19
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3923
Mailing Address - Country:US
Mailing Address - Phone:912-353-1809
Mailing Address - Fax:912-352-3349
Practice Address - Street 1:1100 EISENHOWER DR
Practice Address - Street 2:STE 19
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3923
Practice Address - Country:US
Practice Address - Phone:912-353-1809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000286899BMedicaid
GA000286899BMedicaid