Provider Demographics
NPI:1417096850
Name:MED SUPPLY CABINET, INC
Entity Type:Organization
Organization Name:MED SUPPLY CABINET, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:DORAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-987-3718
Mailing Address - Street 1:101 COMMERCE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MONTGOMERYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18936-9623
Mailing Address - Country:US
Mailing Address - Phone:215-987-3718
Mailing Address - Fax:215-393-8676
Practice Address - Street 1:101 COMMERCE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MONTGOMERYVILLE
Practice Address - State:PA
Practice Address - Zip Code:18936-9623
Practice Address - Country:US
Practice Address - Phone:215-987-3718
Practice Address - Fax:215-393-8676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA8000000850332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3917580001Medicare NSC