Provider Demographics
NPI:1376537159
Name:NEXUS MEDICAL INC
Entity Type:Organization
Organization Name:NEXUS MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-788-4004
Mailing Address - Street 1:2255 COMPUTER RD
Mailing Address - Street 2:UNIT A
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1706
Mailing Address - Country:US
Mailing Address - Phone:215-788-4004
Mailing Address - Fax:215-788-4065
Practice Address - Street 1:2255 COMPUTER RD
Practice Address - Street 2:UNIT A
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1706
Practice Address - Country:US
Practice Address - Phone:215-788-4004
Practice Address - Fax:215-788-4065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA80797191332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016741190005Medicaid
PA1201330001Medicare NSC