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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
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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