Provider Demographics
NPI:1326353954
Name:FASSMED EQUIPMENT & SUPPLIES, INC
Entity Type:Organization
Organization Name:FASSMED EQUIPMENT & SUPPLIES, INC
Other - Org Name:FASSMED, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLATTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-802-1768
Mailing Address - Street 1:P O BOX 761
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18016
Mailing Address - Country:US
Mailing Address - Phone:610-419-1121
Mailing Address - Fax:610-419-1335
Practice Address - Street 1:1421 CENTER STREET
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018
Practice Address - Country:US
Practice Address - Phone:610-419-1121
Practice Address - Fax:610-419-1335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies