Organization
LAUREL MEDICAL SUPPLIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN J LETIZIA ATP (PRESIDENT)
(814) 472-5591
Entity
Organization
Contact information
Practice address
405 S WEST ST, EBENSBURG, PA 15931-1800
(814) 472-5591
(814) 472-7555
Mailing address
PO BOX 4, 405 S. WEST ST., EBENSBURG, PA 15931-0004
(814) 472-5591
(814) 472-7555
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010984030002
—
PA
01
—
281001
HIGHMARK BC BS NUMBER
PA
Enumeration date
11/18/2005
Last updated
02/25/2022
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