Millbourne Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MILLBOURNE MEDICAL SUPPLY LLC

Practice address

6786 Market St Ste 101
Upper Darby, PA 19082-2431

Phone

(610) 553-7368

Fax

(610) 553-7414

NPI assigned

Jul 17, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Xiaobin Li

Title

Owner

Phone

(215) 813-9430

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Millbourne Medical Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • Philadelphia, PA
  • NPI 1760197610

  8527390251

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570579200000",
    "number": "1164944641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6786 MARKET ST STE 101",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190822431",
            "telephone_number": "610-553-7368",
            "fax_number": "610-553-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6786 MARKET ST STE 101",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190822431",
            "telephone_number": "610-553-7368",
            "fax_number": "610-553-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLBOURNE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-17",
        "last_updated": "2019-10-09",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "XIAOBIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-813-9430"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Upper Darby, PA
• Providers in Upper Darby, PA by specialty
• Durable Medical Equipment & Medical Supplies in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.