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General NPI Number Information
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NPI Number | 1134120074
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Entity Type | Organization
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Legal Business Name | TRICOUNTY MEDICAL EQUIPMENT AND SUPPLY, LLC
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 2929 ARCH ST STE 1740, CIRA CENTRE
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City | PHILADELPHIA
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State | PA
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Zip | 19104-2857
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Country | US
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Telephone | 215-739-2238
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Fax | 215-739-1124
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Provider Business Mailing Address
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Address Line | 555 E NORTH LN STE 5075
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City | CONSHOHOCKEN
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State | PA
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Zip | 19428-2490
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CCO
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Name | WENDY RUSSALESI
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Credential |
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Telephone | 484-246-9499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 100793630
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 1000003158
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 600005028
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License Number State | PA
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