Provider Demographics
NPI:1770394124
Name:MEDEDGE LLC
Entity type:Organization
Organization Name:MEDEDGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BECAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-844-7586
Mailing Address - Street 1:18 S 9TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-1630
Mailing Address - Country:US
Mailing Address - Phone:610-844-7586
Mailing Address - Fax:
Practice Address - Street 1:18 S 9TH ST STE 102
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-1630
Practice Address - Country:US
Practice Address - Phone:610-844-7586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies