Organization
PERSONAL SUPPORT MEDICAL SUPPLIERS INC
Active
Parent organization
PERSONAL SUPPORT MEDICAL SUPPLIERS INC
Other names
Personal Support Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
PERSONAL SUPPORT MEDICAL SUPPLIERS INC
Authorized official
DAVID HATOOKA (PRESIDENT)
(215) 464-7304
Entity
Organization
Contact information
Practice address
262 GEIGER RD, PHILADELPHIA, PA 19115
(215) 464-7304
(215) 437-6633
Mailing address
262 GEIGER ROAD, PHILADELPHIA, PA 19115-1008
(215) 464-7304
(215) 437-6633
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
PA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
PA
332BX2000X
Oxygen Equipment & Supplies (DME)
—
PA
333600000X
Pharmacy
PP481409
PA
3336H0001X
Home Infusion Therapy Pharmacy
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001850216-0005
—
PA
05
—
001850216-0007
—
PA
05
—
0072869
—
NJ
Enumeration date
07/07/2005
Last updated
08/08/2018
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