MEDICARE: PAYNE SYSTEMS, 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	82290417	PA

General Provider Information

NPI Number	:	1609067925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAYNE SYSTEMS, INC.

Provider Business Mailing Address
First Line	:	P.O. BOX 583
Second Line	:
City	:	WYNNEWOOD
State	:	PA
Zip	:	19096-0583
Country	:	US
Telephone Number	:	215-680-7259
Fax Number	:

Provider Business Practice Location Address
First Line	:	3035 W DIAMOND ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19121-1142
Country	:	US
Telephone Number	:	215-680-7259
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MS. SHARON H. PAYNE
Credential	:
Telephone Number	:	215-680-7259

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	08/05/2007

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