Provider Demographics
NPI:1699869768
Name:HARRY J. LAWALL & SON, INC.
Entity type:Organization
Organization Name:HARRY J. LAWALL & SON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:T
Authorized Official - Last Name:LAWALL
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:215-338-6611
Mailing Address - Street 1:8031 FRANKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19136-2736
Mailing Address - Country:US
Mailing Address - Phone:800-735-4627
Mailing Address - Fax:215-338-9579
Practice Address - Street 1:1261 SOUTH ROUTE 9
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210
Practice Address - Country:US
Practice Address - Phone:609-463-1042
Practice Address - Fax:609-691-7147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJC0000151495335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier