Provider Demographics
NPI:1952800047
Name:TAYLOR BONEA
Entity Type:Organization
Organization Name:TAYLOR BONEA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MBA, MHA
Authorized Official - Phone:215-559-9211
Mailing Address - Street 1:1932 N STANLEY ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19121-1831
Mailing Address - Country:US
Mailing Address - Phone:215-559-9211
Mailing Address - Fax:
Practice Address - Street 1:1932 N STANLEY ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19121-1831
Practice Address - Country:US
Practice Address - Phone:215-559-9211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies