Healthcare Provider Details

I. General information

NPI: 1922377886
Provider Name (Legal Business Name): LLEWELLYNS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2011
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 MAIN ST
AVOCA PA
18641
US

IV. Provider business mailing address

703 MAIN ST
AVOCA PA
18641-1622
US

V. Phone/Fax

Practice location:
  • Phone: 470-457-2341
  • Fax: 570-457-3224
Mailing address:
  • Phone: 570-457-2341
  • Fax: 570-457-3224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberPP411400L
License Number StatePA

VIII. Authorized Official

Name: MR. JOSEPH DESANTO
Title or Position: PRESIDENT
Credential:
Phone: 570-457-5251