MEDICARE: TALC CORP

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)		PA
2	3336C0003X	Community/Retail Pharmacy	PP4128467	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	91931	OTHER	PA	AETNA

General Provider Information

NPI Number	:	1699773382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TALC CORP

Provider Business Mailing Address
First Line	:	PO BOX 249
Second Line	:
City	:	GLENSIDE
State	:	PA
Zip	:	19038-0249
Country	:	US
Telephone Number	:	215-887-4577
Fax Number	:	215-887-4505

Provider Business Practice Location Address
First Line	:	108 110 S. EASTON RD.
Second Line	:
City	:	GLENSIDE
State	:	PA
Zip	:	19038-0249
Country	:	US
Telephone Number	:	215-887-4577
Fax Number	:	215-887-4505

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	MR. TERRENCE T BAIRD
Credential	:
Telephone Number	:	215-884-2990

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/21/2022

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Directions to “TALC CORP ” Practice Location

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