MEDICARE: ASSOCIATED MEDICAL SPECIALTIES, 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	332BX2000X	Oxygen Equipment & Supplies (DME)	8000000475	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2671433	OTHER	AETNA-HMO
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	5986470	OTHER	AETNA-PPO
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	202886	OTHER	PREMIER BLUE
9	202886	OTHER	PERSONAL CHOICE
10	2598000	OTHER	KEYSTONE HEALTH PLAN EAST
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588669261
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATED MEDICAL SPECIALTIES, INC.

Provider Business Mailing Address
First Line	:	2901 SOUTHAMPTON RD
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19154-1208
Country	:	US
Telephone Number	:	215-677-4486
Fax Number	:	215-677-3644

Provider Business Practice Location Address
First Line	:	2901 SOUTHAMPTON RD
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19154-1208
Country	:	US
Telephone Number	:	215-677-4486
Fax Number	:	215-677-3644

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. MITCHELL I BALABAN
Credential	:
Telephone Number	:	215-677-4486

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	05/06/2011

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