MEDICARE: PROVIDER PLUS, INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies

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	:	1740441229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROVIDER PLUS, INC.

Provider Business Mailing Address
First Line	:	220 W GERMANTOWN PIKE STE 250
Second Line	:
City	:	PLYMOUTH MEETING
State	:	PA
Zip	:	19462-1437
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2512 CREEK TRAIL CT
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65109-9245
Country	:	US
Telephone Number	:	573-634-0048
Fax Number	:	573-634-0037

Authorized Official
Title or Position	:	CEO
Name	:	STEPHEN GRIGGS
Credential	:
Telephone Number	:	407-206-0040

Provider Enumeration Date	:	06/18/2008
Last Update Date	:	07/12/2021

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Directions to “PROVIDER PLUS, INC. ” Practice Location

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