Provider Demographics
NPI:1013926732
Name:FS-PHILADELPHIA LLC
Entity Type:Organization
Organization Name:FS-PHILADELPHIA LLC
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:
Authorized Official - Last Name:GBEWONYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-270-9600
Mailing Address - Street 1:110A W GERMANTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-1348
Mailing Address - Country:US
Mailing Address - Phone:610-270-9600
Mailing Address - Fax:610-314-7736
Practice Address - Street 1:2951 SWEDE RD
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19401
Practice Address - Country:US
Practice Address - Phone:610-270-9600
Practice Address - Fax:610-270-9622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2018-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
PA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5020860001Medicare ID - Type Unspecified