Provider Demographics
NPI:1538145503
Name:MED-EQUIP, INC.
Entity Type:Organization
Organization Name:MED-EQUIP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CCO
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSALESI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-246-9499
Mailing Address - Street 1:122 MILL RD
Mailing Address - Street 2:SUITE A130
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1413
Mailing Address - Country:US
Mailing Address - Phone:610-586-1244
Mailing Address - Fax:610-586-5613
Practice Address - Street 1:1 E BEACON LIGHT LN
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-4433
Practice Address - Country:US
Practice Address - Phone:610-586-1244
Practice Address - Fax:610-586-5613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-21
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2001105761332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011818870004Medicaid
DE1000021430Medicaid
0497620001Medicare NSC