MEDICARE: PORTER LIMITED

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)	8000000764	PA

General Provider Information

NPI Number	:	1679576235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PORTER LIMITED

Provider Business Mailing Address
First Line	:	PO BOX 288
Second Line	:
City	:	DUNMORE
State	:	PA
Zip	:	18512-0288
Country	:	US
Telephone Number	:	570-876-6626
Fax Number	:

Provider Business Practice Location Address
First Line	:	REAR TRAPP PLAZA
Second Line	:	RTE.#6, SCRANTON/CARBONDALE HWY.
City	:	ARCHBALD
State	:	PA
Zip	:	18403
Country	:	US
Telephone Number	:	570-876-6626
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RICHARD BERNARD LANDRY
Credential	:	CRT
Telephone Number	:	570-876-6626

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	08/22/2020

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Directions to “PORTER LIMITED ” Practice Location

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