Organization
TRICOUNTY MEDICAL EQUIPEMENT & SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MICHAEL GVODAS JR. (OWNER)
(610) 705-9292
Entity
Organization
Contact information
Practice address
34 E HIGH ST, POTTSTOWN, PA 19464-5427
(610) 705-9292
(610) 705-9777
Mailing address
34 E HIGH ST, POTTSTOWN, PA 19464-5427
(610) 705-9292
(610) 705-9777
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002789000
INDEPENDANCE BLUE CROSS
PA
05
—
102053991 0001
—
PA
01
—
30048227
KEYSTONE MERCY
PA
Enumeration date
11/19/2007
Last updated
04/30/2008
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