MEDICARE: SMS MR WHEELCHAIR LLC

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	385818	PA

General Provider Information

NPI Number	:	1255659660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMS MR WHEELCHAIR LLC

Provider Business Mailing Address
First Line	:	7932 FRANKFORD AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19136-3016
Country	:	US
Telephone Number	:	215-333-7301
Fax Number	:	215-333-7318

Provider Business Practice Location Address
First Line	:	7932 FRANKFORD AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19136-3016
Country	:	US
Telephone Number	:	215-333-7301
Fax Number	:	215-333-7318

Authorized Official
Title or Position	:	OWNER
Name	:	MS. SALINA SIERRA
Credential	:
Telephone Number	:	215-333-7301

Provider Enumeration Date	:	05/10/2010
Last Update Date	:	05/10/2010

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Directions to “SMS MR WHEELCHAIR LLC ” Practice Location

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