| NPI | 1902200918 |
|---|---|
| Doing Business As | WALLACE HOME MEDICAL SUPPLIES |
| Entity Type | Organization |
| Authorized Contact | MATTHEW TRAGO WALLACE President 805-238-3935 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2015-08-06 |