Provider Demographics
NPI:1407521768
Name:USA DME MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:USA DME MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-298-9582
Mailing Address - Street 1:9237 ROOSEVELT BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-2205
Mailing Address - Country:US
Mailing Address - Phone:215-904-6765
Mailing Address - Fax:
Practice Address - Street 1:9237 ROOSEVELT BLVD STE 103
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-2205
Practice Address - Country:US
Practice Address - Phone:215-904-6765
Practice Address - Fax:215-904-5944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-10
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies