Provider Demographics
NPI:1295904464
Name:MARY LOUISE SCHNEIDERS
Entity type:Organization
Organization Name:MARY LOUISE SCHNEIDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-233-5170
Mailing Address - Street 1:300 BETHLEHEM PIKE
Mailing Address - Street 2:
Mailing Address - City:ERDENHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:19038-8238
Mailing Address - Country:US
Mailing Address - Phone:215-233-5170
Mailing Address - Fax:
Practice Address - Street 1:300 BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:ERDENHEIM
Practice Address - State:PA
Practice Address - Zip Code:19038-8238
Practice Address - Country:US
Practice Address - Phone:215-233-5170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002497L332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5560650001Medicare NSC