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General NPI Number Information
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NPI Number | 1073835039
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Entity Type | Organization
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Legal Business Name | NORTHEAST MEDICAL SALES
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Dates
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Enumeration Date | 02/18/2010
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Last Update Date | 09/21/2015
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Provider Practice Location Address
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Address Line | 2354 OLD POST RD SUITE 2
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City | COPLAY
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State | PA
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Zip | 18037-2461
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Country | US
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Telephone | 610-262-3331
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Fax | 610-262-3399
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Provider Business Mailing Address
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Address Line | 315 JOHNSON RD
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City | SPRINGVILLE
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State | PA
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Zip | 18844-8019
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Country | US
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Telephone | 570-965-0964
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Fax | 570-965-0964
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Authorized Official
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Title or Position | SENIOR PARTNER
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Name | MRS. TAMMI L DANNECKER
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Credential |
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Telephone | 570-965-0964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 6000004877
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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