MEDICARE: PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES, LTD

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1225817125
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES, LTD

Provider Business Mailing Address
First Line	:	PO BOX 5228
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-0405
Country	:	US
Telephone Number	:	610-359-5672
Fax Number	:

Provider Business Practice Location Address
First Line	:	2010 W CHESTER PIKE STE 425
Second Line	:
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-2740
Country	:	US
Telephone Number	:	610-789-9815
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JEFFREY MALUMED
Credential	:
Telephone Number	:	610-521-9996

Provider Enumeration Date	:	09/28/2023
Last Update Date	:	09/28/2023

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