Provider Demographics
NPI:1043526973
Name:DEVON MEDICAL PRODUCTS
Entity Type:Organization
Organization Name:DEVON MEDICAL PRODUCTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:RU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-688-8214
Mailing Address - Street 1:1100 FIRST AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1327
Mailing Address - Country:US
Mailing Address - Phone:484-688-8214
Mailing Address - Fax:484-636-0211
Practice Address - Street 1:1100 FIRST AVE STE 202
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1327
Practice Address - Country:US
Practice Address - Phone:484-688-8214
Practice Address - Fax:484-636-0211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-30
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000006935332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies