Healthcare Provider Details

I. General information

NPI: 1245167683
Provider Name (Legal Business Name): PROACTIVE PAHL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 PLAZA DR APT D02
DOWNINGTOWN PA
19335-3300
US

IV. Provider business mailing address

122 PLAZA DR APT D02
DOWNINGTOWN PA
19335-3300
US

V. Phone/Fax

Practice location:
  • Phone: 484-331-3408
  • Fax: 484-331-3448
Mailing address:
  • Phone: 484-331-3408
  • Fax: 484-331-3448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JAZIB BILAL
Title or Position: OWNER
Credential:
Phone: 484-331-3408