Healthcare Provider Details

I. General information

NPI: 1568419265
Provider Name (Legal Business Name): ALLEGHENY MEDICAL SUPPLIES AND EQUIPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 E COLLEGE AVE SUITE 380
STATE COLLEGE PA
16801-5558
US

IV. Provider business mailing address

444 E COLLEGE AVE SUITE 380
STATE COLLEGE PA
16801-5558
US

V. Phone/Fax

Practice location:
  • Phone: 814-238-2247
  • Fax: 814-238-2264
Mailing address:
  • Phone: 814-238-2247
  • Fax: 814-238-2264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberNOT REQUIRED FROM US
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name: MS. CAROLINE NYUBUMAYA EGBELU
Title or Position: VICE PRESIDENT
Credential:
Phone: 814-238-2247