MEDICARE: MEDSURGE GROUP, 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	4000007089	PA

General Provider Information

NPI Number	:	1710950415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDSURGE GROUP, INC.

Provider Business Mailing Address
First Line	:	8205 DOUGLAS RD
Second Line	:
City	:	WYNDMOOR
State	:	PA
Zip	:	19038-7507
Country	:	US
Telephone Number	:	215-836-1314
Fax Number	:

Provider Business Practice Location Address
First Line	:	6112 GERMANTOWN AVE
Second Line	:	SUITE 1F
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-2048
Country	:	US
Telephone Number	:	215-843-5205
Fax Number	:	215-843-5206

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. WANDA GBEMUDU
Credential	:	RN
Telephone Number	:	215-843-5205

Provider Enumeration Date	:	02/12/2006
Last Update Date	:	08/22/2020

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