MEDICARE: HARRY J LAWALL & SON, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier		PA

General Provider Information

NPI Number	:	1134129166
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRY J LAWALL & SON, INC.

Provider Business Mailing Address
First Line	:	3000 CABOT BLVD W
Second Line	:
City	:	LANGHORNE
State	:	PA
Zip	:	19047-1800
Country	:	US
Telephone Number	:	215-338-6611
Fax Number	:	215-338-9579

Provider Business Practice Location Address
First Line	:	8028 FRANKFORD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-2616
Country	:	US
Telephone Number	:	215-338-6611
Fax Number	:	215-338-9579

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. WAYNE LAWALL
Credential	:	CPO
Telephone Number	:	215-338-6611

Provider Enumeration Date	:	08/01/2005
Last Update Date	:	10/25/2023

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