Provider Demographics
NPI:1306403811
Name:DEVON MD LLC
Entity Type:Organization
Organization Name:DEVON MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-751-5065
Mailing Address - Street 1:700 AMERICAN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-4031
Mailing Address - Country:US
Mailing Address - Phone:484-704-7017
Mailing Address - Fax:610-422-2551
Practice Address - Street 1:700 AMERICAN AVE STE 100
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-4031
Practice Address - Country:US
Practice Address - Phone:484-704-7017
Practice Address - Fax:610-422-2551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies