Organization
INCREDIBLE MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY DRAZEK (OWNER)
(215) 245-4555
Entity
Organization
Contact information
Practice address
3466 PROGRESS DR, SUITE 113, BENSALEM, PA 19020-5814
(215) 245-4555
(215) 245-4552
Mailing address
3466 PROGRESS DR, SUITE 113, BENSALEM, PA 19020-5814
(215) 245-4555
(215) 245-4552
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Enumeration date
04/12/2017
Last updated
04/12/2017
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