Wilderness Shores Supplies, LLC
NPI #1144545054 in Maple Valley, Washington
Provider Information
- NPI Number
- 1144545054
- Entity Type
- Organization
- Organization Name
- Wilderness Shores Supplies, LLC
- Primary Specialty
- Durable Medical Equipment & Medical Supplies - Parenteral & Enteral Nutrition
- Enumeration Date
- Apr 2, 2010
- Last Updated
- Apr 2, 2010
Practice Location
- Address
- 25614 LAKE WILDERNESS LN SE
- City
- Maple Valley
- State
- Washington
- ZIP Code
- 98038-6019
- Phone
- (206) 931-5284
Authorized Official
- Name
- MRS. SHIRLEY ANN MCMONAGLE
- Title
- OWNER
- Phone
- (206) 931-5284
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies - Oxygen Equipment & Supplies — Oxygen Equipment & Supplies |
| Durable Medical Equipment & Medical Supplies - Parenteral & Enteral Nutrition — Parenteral & Enteral Nutrition |
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