Provider Demographics
NPI:1477956480
Name:ACCUMED MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:ACCUMED MEDICAL SUPPLIES
Other - Org Name:ACCUMED MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-642-7165
Mailing Address - Street 1:5205 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-5027
Mailing Address - Country:US
Mailing Address - Phone:800-642-7165
Mailing Address - Fax:
Practice Address - Street 1:5205 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19143-5027
Practice Address - Country:US
Practice Address - Phone:800-642-7165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACCUMED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-04
Last Update Date:2014-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies