Provider Demographics
NPI:1689008575
Name:PDP MEDICAL SOLUTIONS, LLC
Entity Type:Organization
Organization Name:PDP MEDICAL SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KINGSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-953-7250
Mailing Address - Street 1:376 S SUMMIT AVE
Mailing Address - Street 2:COURT E
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-2987
Mailing Address - Country:US
Mailing Address - Phone:630-953-7250
Mailing Address - Fax:
Practice Address - Street 1:8647 W 95TH ST
Practice Address - Street 2:
Practice Address - City:HICKORY HILLS
Practice Address - State:IL
Practice Address - Zip Code:60457-1730
Practice Address - Country:US
Practice Address - Phone:630-953-7250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies