Provider Demographics
NPI:1023068616
Name:NORTHEAST MEDICAL SALES
Entity type:Organization
Organization Name:NORTHEAST MEDICAL SALES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMI
Authorized Official - Middle Name:L
Authorized Official - Last Name:DANNECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-836-5881
Mailing Address - Street 1:67 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:TUNKHANNOCK
Mailing Address - State:PA
Mailing Address - Zip Code:18657-1503
Mailing Address - Country:US
Mailing Address - Phone:570-836-5881
Mailing Address - Fax:570-836-3081
Practice Address - Street 1:67 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657-1503
Practice Address - Country:US
Practice Address - Phone:570-836-5881
Practice Address - Fax:570-836-3081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies