Provider Demographics
NPI:1235495995
Name:CENTURY ONE MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:CENTURY ONE MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:CHAVARRIA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:267-266-3298
Mailing Address - Street 1:PO BOX 557
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-0557
Mailing Address - Country:US
Mailing Address - Phone:267-266-3298
Mailing Address - Fax:
Practice Address - Street 1:1000 EASTON RD
Practice Address - Street 2:UNIT 2245
Practice Address - City:WYNCOTE
Practice Address - State:PA
Practice Address - Zip Code:19095-2918
Practice Address - Country:US
Practice Address - Phone:267-266-3298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies