Provider Demographics
NPI:1871644641
Name:NORTHEAST MEDICAL SUPPLY CO.,INC.
Entity Type:Organization
Organization Name:NORTHEAST MEDICAL SUPPLY CO.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHESNIAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-237-7195
Mailing Address - Street 1:924 EXETER AVE
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:PA
Mailing Address - Zip Code:18643-1215
Mailing Address - Country:US
Mailing Address - Phone:570-655-7330
Mailing Address - Fax:
Practice Address - Street 1:924 EXETER AVE
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:PA
Practice Address - Zip Code:18643-1215
Practice Address - Country:US
Practice Address - Phone:570-655-7330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies