Old Trail Sales LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

84766110 Issued in PA

Legal business name

OLD TRAIL SALES LLC

Practice address

3620 Old Trail Rd
York Haven, PA 17370-9734

Phone

(717) 932-4831

Fax

(717) 932-4830

NPI assigned

May 4, 2009

Last updated

May 4, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Susan Marie Pica

Title

Owner

Phone

(717) 932-4831

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1241395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241395200000",
    "number": "1194959312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 OLD TRAIL RD",
            "city": "YORK HAVEN",
            "state": "PA",
            "postal_code": "173709734",
            "telephone_number": "717-932-4831",
            "fax_number": "717-932-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 OLD TRAIL RD",
            "city": "YORK HAVEN",
            "state": "PA",
            "postal_code": "173709734",
            "telephone_number": "717-932-4831",
            "fax_number": "717-932-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TRAIL SALES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-04",
        "last_updated": "2009-05-04",
        "status": "A",
        "authorized_official_last_name": "PICA",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-932-4831",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "84766110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in York Haven, PA
• Providers in York Haven, 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 May 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.