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General NPI Number Information
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NPI Number | 1477699759
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Entity Type | Organization
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Legal Business Name | EMMANUEL MEDICAL EQUIPMENT SUPPLY
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1986 MERLIN RD
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City | PHILADELPHIA
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State | PA
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Zip | 19116-3844
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Country | US
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Telephone | 215-934-5181
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Fax |
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Provider Business Mailing Address
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Address Line | 1986 MERLIN RD
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City | PHILADELPHIA
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State | PA
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Zip | 19116-3844
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Country | US
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Telephone | 215-934-5181
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. NINAN KOSHY
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Credential |
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Telephone | 215-934-5181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 3662998
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License Number State | PA
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