Provider Demographics
NPI:1285030973
Name:MED PLUS
Entity Type:Organization
Organization Name:MED PLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SRIVASTAVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-374-8555
Mailing Address - Street 1:1575 N OLD TRL
Mailing Address - Street 2:
Mailing Address - City:SELINSGROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17870-8381
Mailing Address - Country:US
Mailing Address - Phone:570-374-8555
Mailing Address - Fax:570-374-9933
Practice Address - Street 1:1575 N OLD TRL
Practice Address - Street 2:
Practice Address - City:SELINSGROVE
Practice Address - State:PA
Practice Address - Zip Code:17870-8381
Practice Address - Country:US
Practice Address - Phone:570-374-8555
Practice Address - Fax:570-374-9933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies