MEDICARE: EAGLE MEDICAL EQUIPMENT CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	3000008451	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063656098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAGLE MEDICAL EQUIPMENT CORPORATION

Provider Business Mailing Address
First Line	:	5944 STEUBENVILLE PIKE
Second Line	:
City	:	MC KEES ROCKS
State	:	PA
Zip	:	15136-1315
Country	:	US
Telephone Number	:	724-218-1051
Fax Number	:	724-218-1165

Provider Business Practice Location Address
First Line	:	5944 STEUBENVILLE PIKE
Second Line	:
City	:	MC KEES ROCKS
State	:	PA
Zip	:	15136-1315
Country	:	US
Telephone Number	:	724-218-1051
Fax Number	:	724-218-1165

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SHAISTA HASAN
Credential	:
Telephone Number	:	724-218-1051

Provider Enumeration Date	:	04/21/2009
Last Update Date	:	04/04/2014

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