Provider Demographics
NPI:1528154598
Name:WHEELCHAIR RESOURCES INC
Entity type:Organization
Organization Name:WHEELCHAIR RESOURCES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:NRRTS RTS
Authorized Official - Phone:270-826-5440
Mailing Address - Street 1:2701 SAINT PATRICK DRIVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420
Mailing Address - Country:US
Mailing Address - Phone:270-826-5440
Mailing Address - Fax:270-826-5440
Practice Address - Street 1:2701 SAINT PATRICK DRIVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420
Practice Address - Country:US
Practice Address - Phone:270-826-5440
Practice Address - Fax:270-826-5440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY45901279332BC3200X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY45901279Medicaid
KY90080516Medicaid
KY90080516Medicaid