Provider Demographics
NPI:1669629119
Name:CAREGIVERS AMERICA MEDICAL SUPPLY, LLC
Entity Type:Organization
Organization Name:CAREGIVERS AMERICA MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MIA
Authorized Official - Middle Name:LENORA
Authorized Official - Last Name:HANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-586-2222
Mailing Address - Street 1:718 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411-1749
Mailing Address - Country:US
Mailing Address - Phone:570-586-8888
Mailing Address - Fax:570-586-5225
Practice Address - Street 1:718 S STATE ST
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-1749
Practice Address - Country:US
Practice Address - Phone:570-586-8888
Practice Address - Fax:570-586-5225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022895740003Medicaid
PA1022895740003Medicaid