MEDICARE: PENNSYLVANIA ORTHOPAEDIC ASSOCIATES 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 State	Provider Identifier Issuer
1	0003000000	OTHER	PA	IBC PROVIDER NUMBE

General Provider Information

NPI Number	:	1588997258
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENNSYLVANIA ORTHOPAEDIC ASSOCIATES INC

Provider Business Mailing Address
First Line	:	727 WELSH RD
Second Line	:	SUITE 103
City	:	HUNTINGDON VALLEY
State	:	PA
Zip	:	19006-6310
Country	:	US
Telephone Number	:	215-947-7550
Fax Number	:	215-947-0590

Provider Business Practice Location Address
First Line	:	727 WELSH RD
Second Line	:	SUITE 103
City	:	HUNTINGDON VALLEY
State	:	PA
Zip	:	19006-6310
Country	:	US
Telephone Number	:	215-947-7550
Fax Number	:	215-947-0590

Authorized Official
Title or Position	:	PARTNER
Name	:	DOUGLAS SUTTON
Credential	:	MD
Telephone Number	:	215-947-7550

Provider Enumeration Date	:	09/14/2009
Last Update Date	:	09/28/2009

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