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General NPI Number Information
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NPI Number | 1710950415
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Entity Type | Organization
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Legal Business Name | MEDSURGE GROUP, INC.
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Dates
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Enumeration Date | 02/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6112 GERMANTOWN AVE SUITE 1F
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City | PHILADELPHIA
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State | PA
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Zip | 19144-2048
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Country | US
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Telephone | 215-843-5205
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Fax | 215-843-5206
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Provider Business Mailing Address
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Address Line | 8205 DOUGLAS RD
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City | WYNDMOOR
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State | PA
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Zip | 19038-7507
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Country | US
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Telephone | 215-836-1314
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. WANDA GBEMUDU
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Credential | RN
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Telephone | 215-843-5205
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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 | 4000007089
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License Number State | PA
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