Healthcare Provider Details
I. General information
NPI: 1366681470
Provider Name (Legal Business Name): BEST MEDICAL SUPPLY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/12/2009
Last Update Date: 08/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13023 BUSTLETON AVE
PHILADELPHIA PA
19116-1672
US
IV. Provider business mailing address
13023 BUSTLETON AVENUE BEST MEDICAL SUPPLY, INC.
PHILADELPHIA PA
19116-1672
US
V. Phone/Fax
- Phone: 215-904-7815
- Fax: 215-904-7817
- Phone: 215-904-7815
- Fax: 215-904-7817
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | 466083 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | 466083 |
| License Number State | PA |
VIII. Authorized Official
Name:
LALA
ZADE
Title or Position: PRESIDENT
Credential:
Phone: 215-904-7815