Organization
ULYSEES GAMMAGE JR
Active
Other names
Universale Pedorthic Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ULYSEES GAMMAGE JR. (OWNER)
(215) 776-0981
Entity
Organization
Contact information
Practice address
6037 CASTOR AVE, PHILADELPHIA, PA 19149-3207
(215) 776-0981
(215) 224-6611
Mailing address
6037 CASTOR AVE, PHILADELPHIA, PA 19149-3207
(215) 776-0981
(215) 224-6611
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
6000005706
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005113000
PERSONAL CHOICE
PA
Enumeration date
03/27/2007
Last updated
08/04/2008
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