MEDICARE: NEB DOCTORS OF WESTERN PENNSYLVANIA LLC

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)	6000006759	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	:	1073588570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEB DOCTORS OF WESTERN PENNSYLVANIA LLC

Provider Business Mailing Address
First Line	:	850 BOYCE RD STE 5
Second Line	:
City	:	BRIDGEVILLE
State	:	PA
Zip	:	15017-1541
Country	:	US
Telephone Number	:	412-653-3750
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 BOYCE RD STE 5
Second Line	:
City	:	BRIDGEVILLE
State	:	PA
Zip	:	15017-1541
Country	:	US
Telephone Number	:	412-653-3750
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RANDY PAULSON
Credential	:
Telephone Number	:	513-200-2105

Provider Enumeration Date	:	02/20/2006
Last Update Date	:	11/15/2023

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