Organization
FAIRWAY MEDICAL SERVICES,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STANLEY MOLDOVER (PRESIDENT)
(267) 778-9193
Entity
Organization
Contact information
Practice address
275 KINGSCLERE DR, SOUTHAMPTON, PA 18966-3033
(267) 778-9193
(267) 778-9194
Mailing address
275 KINGSCLERE DR, SOUTHAMPTON, PA 18966-3033
(267) 778-9193
(267) 778-9194
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
6000004474
PA
Other
Enumeration date
07/17/2009
Last updated
02/10/2017
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