Provider Demographics
NPI:1780871640
Name:NORTH WALES HAND REHABILITATION, INC.
Entity type:Organization
Organization Name:NORTH WALES HAND REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:LEITH
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT CHT
Authorized Official - Phone:215-699-2844
Mailing Address - Street 1:102 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-3319
Mailing Address - Country:US
Mailing Address - Phone:215-699-2844
Mailing Address - Fax:215-699-2845
Practice Address - Street 1:102 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-3319
Practice Address - Country:US
Practice Address - Phone:215-699-2844
Practice Address - Fax:215-699-2845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007517170004Medicaid
PA1007517170004Medicaid
PA1299990001Medicare NSC