Provider Demographics
NPI:1255390977
Name:SLATE BELT MEDICAL EQUIPMENT & SUPPLIES INC
Entity type:Organization
Organization Name:SLATE BELT MEDICAL EQUIPMENT & SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:S
Authorized Official - Last Name:FLAIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-863-9157
Mailing Address - Street 1:457 BLUE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:PA
Mailing Address - Zip Code:18013-1513
Mailing Address - Country:US
Mailing Address - Phone:610-863-9157
Mailing Address - Fax:610-863-5698
Practice Address - Street 1:457 BLUE VALLEY DR
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:PA
Practice Address - Zip Code:18013-1513
Practice Address - Country:US
Practice Address - Phone:610-863-9157
Practice Address - Fax:610-863-5698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017379800001Medicaid
1543507OtherGATEWAY
0007378107OtherAETNA
A36545334OtherOXFORD
39HA75OtherCAPITAL BLUE
1230430001Medicare ID - Type Unspecified
PA0017379800001Medicaid