Provider Demographics
NPI:1710445309
Name:SHAY AND IBN MANAGEMENT
Entity Type:Organization
Organization Name:SHAY AND IBN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DINAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-331-8905
Mailing Address - Street 1:PO BOX 52283
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-7283
Mailing Address - Country:US
Mailing Address - Phone:215-842-5128
Mailing Address - Fax:267-297-5181
Practice Address - Street 1:5313 N 5TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19120-3203
Practice Address - Country:US
Practice Address - Phone:267-331-8905
Practice Address - Fax:267-297-8191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1922563402OtherN/A