Provider Demographics
NPI:1811311053
Name:NATIONWIDE MEDICAL, INC
Entity type:Organization
Organization Name:NATIONWIDE MEDICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-338-3500
Mailing Address - Street 1:29901 AGOURA RD
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-2513
Mailing Address - Country:US
Mailing Address - Phone:818-338-3500
Mailing Address - Fax:818-338-3501
Practice Address - Street 1:2550 BROWNSVILLE RD
Practice Address - Street 2:SUITE 8
Practice Address - City:SOUTH PARK
Practice Address - State:PA
Practice Address - Zip Code:15129-7500
Practice Address - Country:US
Practice Address - Phone:724-314-3764
Practice Address - Fax:724-314-3698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-07
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000008445332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies