Organization
MILLBOURNE MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
XIAOBIN LI (OWNER)
(215) 813-9430
Entity
Organization
Contact information
Practice address
649 FOULKROD ST UNIT 306, PHILADELPHIA, PA 19120-2125
(610) 553-7368
Mailing address
649 FOULKROD ST UNIT 306, PHILADELPHIA, PA 19120-2125
(610) 553-7368
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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