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A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient?s use in the home and that are usable for an extended period of time.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company | |
Community/Retail Pharmacy |
3336C0003X | 58 | Medical Supply Company with Pharmacist | |
Customized Equipment |
332BC3200X | 87 | All Other Suppliers | |
Home Infusion Therapy Pharmacy |
3336H0001X | 58 | Medical Supply Company with Pharmacist | |
Long Term Care Pharmacy |
3336L0003X | 58 | Medical Supply Company with Pharmacist | |
Mail Order Pharmacy |
3336M0002X | 58 | Medical Supply Company with Pharmacist | |
Oxygen Equipment & Supplies |
332BX2000X | B1 | Oxygen supplier | |
Parenteral & Enteral Nutrition |
332BP3500X | 87 | All Other Suppliers | |
Pharmacy |
333600000X | 58 | Medical Supply Company with Pharmacist | |
Specialty Pharmacy |
3336S0011X | 58 | Medical Supply Company with Pharmacist |
| NPI Number | 1568571420 |
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| LBN Legal business name | WAUCONDA PHARMACY, INC. | ||||||||||||||||
| Authorized official | TERRY BRUNER - (MANAGER) | ||||||||||||||||
| Entity | Organization | ||||||||||||||||
| Organization subpart 1 | No | ||||||||||||||||
| Enumeration date | 08/30/2006 | ||||||||||||||||
| Last updated | 11/07/2011 - About 15 years ago | ||||||||||||||||
| Identifiers |
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WAUCONDA PHARMACY, INC.