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General NPI Number Information
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NPI Number | 1629264205
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Entity Type | Organization
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Legal Business Name | DEBADON LLC
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 2711 EDGMONT AVE
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City | BROOKHAVEN
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State | PA
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Zip | 19015-3316
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Country | US
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Telephone | 610-876-4935
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Fax | 610-876-5940
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Provider Business Mailing Address
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Address Line | 2711 EDGMONT AVE
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City | BROOKHAVEN
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State | PA
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Zip | 19015-3316
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Country | US
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Telephone | 610-876-4935
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Fax | 610-876-5940
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Authorized Official
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Title or Position | OWNER
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Name | MR. DONALD BRUCE ASPLEN
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Credential |
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Telephone | 610-876-4935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | D00914
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 6000007099
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License Number State | PA
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