Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Nursing Facility Supplies |
332BN1400X | 87 | All Other Suppliers | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company | |
Parenteral & Enteral Nutrition |
332BP3500X | 87 | All Other Suppliers |
| NPI Number | 1124239751 |
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| LBN Legal business name | WESTERN HOME | ||||
| Authorized official | JERRY HARRIS - (PRESIDENT) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 05/25/2007 | ||||
| Last updated | 04/23/2009 - About 17 years ago | ||||
| Identifiers |
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