Healthcare Provider Details

I. General information

NPI: 1336955855
Provider Name (Legal Business Name): MCCOY MEDICAL EQUIPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2024
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 PUSEY AVE STE 250
COLLINGDALE PA
19023-3309
US

IV. Provider business mailing address

520 PUSEY AVE STE 250
COLLINGDALE PA
19023-3309
US

V. Phone/Fax

Practice location:
  • Phone: 215-900-9382
  • Fax: 610-934-2911
Mailing address:
  • Phone: 215-900-9382
  • Fax: 610-934-2911

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 Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MS. KEYZIAH MCCOY
Title or Position: OWNER
Credential:
Phone: 610-461-3709