Provider Demographics
NPI:1194852632
Name:TWIN TIER MANAGEMENT CORP INC
Entity Type:Organization
Organization Name:TWIN TIER MANAGEMENT CORP INC
Other - Org Name:DBA MED SUPPLY DEPOT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROEGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-887-4453
Mailing Address - Street 1:124 COLONIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:TOWANDA
Mailing Address - State:PA
Mailing Address - Zip Code:18848-9707
Mailing Address - Country:US
Mailing Address - Phone:570-268-2140
Mailing Address - Fax:570-268-4168
Practice Address - Street 1:124 COLONIAL DRIVE
Practice Address - Street 2:
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848-9707
Practice Address - Country:US
Practice Address - Phone:570-268-2140
Practice Address - Fax:570-268-4168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BP3500X, 332BX2000X, 335E00000X
PA3000007393332BC3200X, 332BP3500X, 332BX2000X, 335E00000X
PA335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0305220007Medicare NSC