Organization
JOHN W PHIPPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN W PHIPPS (OWNER)
(607) 739-8616
Entity
Organization
Contact information
Practice address
1133 WILLOW ST, HORSEHEADS, NY 14845-2806
(607) 739-8616
(607) 739-1655
Mailing address
1133 WILLOW ST, HORSEHEADS, NY 14845-2806
(607) 739-8616
(607) 739-1655
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01793553
—
NY
05
—
1201264
—
PA
01
—
1B000002124
BLUE CROSS/ BLUE SHEILD
NY
Enumeration date
11/08/2007
Last updated
11/08/2007
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