MEDICARE: SLATE BELT MEDICAL EQUIPMENT & SUPPLIES 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	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1543507	OTHER	GATEWAY
3	0007378107	OTHER	AETNA
4	A36545334	OTHER	OXFORD
5	39HA75	OTHER	CAPITAL BLUE

General Provider Information

NPI Number	:	1255390977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLATE BELT MEDICAL EQUIPMENT & SUPPLIES INC

Provider Business Mailing Address
First Line	:	457 BLUE VALLEY DR
Second Line	:
City	:	BANGOR
State	:	PA
Zip	:	18013-1513
Country	:	US
Telephone Number	:	610-863-9157
Fax Number	:	610-863-5698

Provider Business Practice Location Address
First Line	:	457 BLUE VALLEY DR
Second Line	:
City	:	BANGOR
State	:	PA
Zip	:	18013-1513
Country	:	US
Telephone Number	:	610-863-9157
Fax Number	:	610-863-5698

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KATHRYN S FLAIM
Credential	:
Telephone Number	:	610-863-9157

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	08/22/2020

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