MEDICARE: MEDEDGE 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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1770394124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDEDGE LLC

Provider Business Mailing Address
First Line	:	18 S 9TH ST STE 102
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-1630
Country	:	US
Telephone Number	:	610-844-7586
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 S 9TH ST STE 102
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-1630
Country	:	US
Telephone Number	:	610-844-7586
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MATTHEW BECAN
Credential	:
Telephone Number	:	610-844-7586

Provider Enumeration Date	:	01/15/2025
Last Update Date	:	01/15/2025

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Directions to “MEDEDGE LLC ” Practice Location

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