Healthcare Provider Details

I. General information

NPI: 1982655916
Provider Name (Legal Business Name): ASSOCIATED SURGICAL SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 E 5TH ST
MOUNT CARMEL PA
17851-2179
US

IV. Provider business mailing address

31 E 5TH ST
MOUNT CARMEL PA
17851-2179
US

V. Phone/Fax

Practice location:
  • Phone: 570-339-4171
  • Fax: 570-339-4955
Mailing address:
  • Phone: 570-339-4171
  • Fax: 570-339-4955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. WILLIAM JOHN SCHULTZ SR.
Title or Position: PRESIDENT
Credential:
Phone: 570-339-4001