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NPI Code Detail

MEDICARE: ROBERTS HOME MEDICAL LLC

MEDICARE: ROBERTS HOME MEDICAL LLC
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
1332BC3200XCustomized Equipment (DME)
2335E00000XProsthetic/Orthotic Supplier
3332BP3500XParenteral & Enteral Nutrition Supplies (DME)
4332B00000XDurable Medical Equipment & Medical Supplies
5332BX2000XOxygen Equipment & Supplies (DME)

General Provider Information

NPI Number : 1720610504
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROBERTS HOME MEDICAL LLC
Provider Business Mailing Address
First Line : 555 E NORTH LN STE 5075
Second Line :
City : CONSHOHOCKEN
State : PA
Zip : 19428-2490
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 135 IMBODEN DR
Second Line :
City : WINCHESTER
State : VA
Zip : 22603-5784
Country : US
Telephone Number : 540-378-6165
Fax Number :
Authorized Official
Title or Position : CCO
Name : WENDY RUSSALESI
Credential :
Telephone Number : 484-246-9499
Provider Enumeration Date : 02/10/2020
Last Update Date : 06/01/2026

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