Provider Demographics
NPI:1093761074
Name:CRESSCARE MEDICAL INC
Entity Type:Organization
Organization Name:CRESSCARE MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:GRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:CRT, CCT, BS ED
Authorized Official - Phone:407-206-0040
Mailing Address - Street 1:1820 LINGLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-3339
Mailing Address - Country:US
Mailing Address - Phone:717-232-3188
Mailing Address - Fax:717-232-1072
Practice Address - Street 1:1531 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-9166
Practice Address - Country:US
Practice Address - Phone:717-241-4441
Practice Address - Fax:717-241-6118
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AEROCARE HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-25
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3000008902332B00000X
332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007581550016Medicaid
PA4327860003Medicare NSC