Organization
ALL MEDICAL & EQUIPMENT SUPPLIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IFIOK E ENYONG (PRESIDENT CEO)
(717) 246-8900
Entity
Organization
Contact information
Practice address
45 S MAIN ST, RED LION, PA 17356-2118
(717) 246-8900
(717) 246-8982
Mailing address
45 S MAIN ST, RED LION, PA 17356-2118
(717) 246-8900
(717) 246-8982
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
3000007233
PA
332BC3200X
Customized Equipment (DME)
3000007233
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000143380
—
PA
Enumeration date
08/02/2005
Last updated
07/21/2015
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