Medical Wig LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MEDICAL WIG LLC

Practice address

2424 W Oakland Park Blvd Ste 109
Oakland Park, FL 33311-1414

Phone

(800) 342-9913

NPI assigned

Nov 20, 2024

Last updated

Nov 20, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Julie Clark, CRANIAL PROSTHESIS

Title

Ceo

Phone

(800) 342-9913

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1427873975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 S FLAMINGO RD STE 106",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333301902",
            "telephone_number": "800-342-9913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 W OAKLAND PARK BLVD STE 109",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333111414",
            "telephone_number": "800-342-9913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL WIG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "800-342-9913",
        "authorized_official_credential": "CRANIAL PROSTHESIS"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.