Organization
LOGOS MEDICAL SUPPLY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN WILCHER (PRESIDENT)
(215) 452-5701
Entity
Organization
Contact information
Practice address
5070 PARKSIDE AVE, SUITE 5100W, PHILADELPHIA, PA 19131-4747
(215) 452-5701
(215) 452-0443
Mailing address
5070 PARKSIDE AVE, SUITE 5100W, PHILADELPHIA, PA 19131-4747
(215) 452-5701
(215) 452-0443
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
156245
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020765750001
—
PA
Enumeration date
03/20/2007
Last updated
02/17/2016
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