MEDICARE: POUVOIR COMPANY 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	OEG000488	PA
2	302F00000X	Exclusive Provider Organization	OEG000488	PA

General Provider Information

NPI Number	:	1780848291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POUVOIR COMPANY LLC

Provider Business Mailing Address
First Line	:	203 N REDWOOD ST
Second Line	:
City	:	MASONTOWN
State	:	PA
Zip	:	15461-1668
Country	:	US
Telephone Number	:	724-583-7793
Fax Number	:	724-583-9515

Provider Business Practice Location Address
First Line	:	203 N REDWOOD ST
Second Line	:
City	:	MASONTOWN
State	:	PA
Zip	:	15461-1668
Country	:	US
Telephone Number	:	724-583-7793
Fax Number	:	724-583-9515

Authorized Official
Title or Position	:	OFFICE CO-ORDINATOR
Name	:	MRS. TERRY J HOIST
Credential	:
Telephone Number	:	724-626-3937

Provider Enumeration Date	:	07/14/2008
Last Update Date	:	01/20/2009

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Directions to “POUVOIR COMPANY LLC ” Practice Location

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