Healthcare Provider Details

I. General information

NPI: 1548292329
Provider Name (Legal Business Name): IE MED SYSTEMS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5095 CENTER ROAD
LATROBE PA
15650
US

IV. Provider business mailing address

480 NORRISTOWN RD SUITE B&C
BLUE BELL PA
19422-2355
US

V. Phone/Fax

Practice location:
  • Phone: 724-537-8303
  • Fax:
Mailing address:
  • Phone: 800-879-6137
  • Fax: 847-913-9024

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 Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: LORI ZSITEK
Title or Position: VICE PRESIDENT AND ASST SECRETARY
Credential:
Phone: 800-879-6137