Organization
PETER L. KING D.P.M.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN VIOLA (OFFICE MANAGER)
(610) 623-1599
Entity
Organization
Contact information
Practice address
2245 GARRETT RD, DREXEL HILL, PA 19026-1101
(610) 623-1599
(610) 623-9066
Mailing address
2245 GARRETT RD, DREXEL HILL, PA 19026-1101
(610) 623-1599
(610) 623-9066
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
SC002869L
PA
332BC3200X
Customized Equipment (DME)
SC002869L
PA
335E00000X
Prosthetic/Orthotic Supplier
SC002869L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010971100001
—
PA
01
—
0060355000
KEYSTONE HEALTH PLAN EAST
PA
Enumeration date
12/11/2007
Last updated
02/07/2008
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