MEDICARE: ORTHOPEDIC SUPPLY 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

General Provider Information

NPI Number	:	1548458391
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOPEDIC SUPPLY INC

Provider Business Mailing Address
First Line	:	196 W ASHLAND ST
Second Line	:	SUITE 311
City	:	DOYLESTOWN
State	:	PA
Zip	:	18901-4040
Country	:	US
Telephone Number	:	215-677-6194
Fax Number	:

Provider Business Practice Location Address
First Line	:	196 W ASHLAND ST
Second Line	:	SUITE 311
City	:	DOYLESTOWN
State	:	PA
Zip	:	18901-4040
Country	:	US
Telephone Number	:	215-677-6194
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ANDREI LEMIASHEUSKI
Credential	:
Telephone Number	:	215-677-6194

Provider Enumeration Date	:	10/05/2007
Last Update Date	:	10/05/2007

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