Provider Demographics
NPI:1841291820
Name:ALL MEDICAL & EQUIPMENT SUPPLIES
Entity type:Organization
Organization Name:ALL MEDICAL & EQUIPMENT SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:IFIOK
Authorized Official - Middle Name:E
Authorized Official - Last Name:ENYONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-246-8900
Mailing Address - Street 1:45 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RED LION
Mailing Address - State:PA
Mailing Address - Zip Code:17356-2118
Mailing Address - Country:US
Mailing Address - Phone:717-246-8900
Mailing Address - Fax:717-246-8982
Practice Address - Street 1:45 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RED LION
Practice Address - State:PA
Practice Address - Zip Code:17356-2118
Practice Address - Country:US
Practice Address - Phone:717-246-8900
Practice Address - Fax:717-246-8982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3000007233332BC3200X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000143380Medicaid
PA4523790001Medicare NSC