Provider Demographics
NPI:1598857146
Name:SEVENTH STREET MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:SEVENTH STREET MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:IRVING
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOLNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-396-2450
Mailing Address - Street 1:307 E PENNSYLVANIA BLVD
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-7846
Mailing Address - Country:US
Mailing Address - Phone:215-396-2450
Mailing Address - Fax:215-396-2454
Practice Address - Street 1:307 E PENNSYLVANIA BLVD
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-7846
Practice Address - Country:US
Practice Address - Phone:215-396-2450
Practice Address - Fax:215-396-2454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0001501251Medicaid
PA15709OtherSENIOR AND HEALTH PARTNER
PA203304OtherHIGHMARK BLUE CROSS
PA0002714000OtherINDEPENDENCE BLUE CROSS
PA117379600OtherDEPARTMENT OF LABOR
PA2186399OtherAETNA US HEALTHCARE
PA1051209OtherKEYSTONE MERCY
PA2186399OtherAETNA US HEALTHCARE
PA203304OtherHIGHMARK BLUE CROSS