Healthcare Provider Details

I. General information

NPI: 1073708459
Provider Name (Legal Business Name): AMD MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 09/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 HUDSON AVE SUITE C
SCRANTON PA
18510
US

IV. Provider business mailing address

201 HUDSON AVE SUITE C
SCRANTON PA
18510
US

V. Phone/Fax

Practice location:
  • Phone: 570-558-0690
  • Fax:
Mailing address:
  • Phone: 570-558-0690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. ALLAN J PISARZ
Title or Position: PRESIDENT
Credential:
Phone: 570-558-0690