Organization
LYMPHEDEMA PLACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICOLAS A RODRIGUEZ (PRESIDENT)
(724) 931-5555
Entity
Organization
Contact information
Practice address
689 N HERMITAGE RD, STE 4, HERMITAGE, PA 16148-3203
(724) 931-5555
(866) 792-8501
Mailing address
1631 ROOSEVELT RD, PITTSBURGH, PA 15237-1048
(724) 931-5555
(866) 792-8501
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
6000007482
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024655640001
—
PA
Enumeration date
09/22/2009
Last updated
01/02/2011
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