Profile Shop, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

6000005802 Issued in PA

Legal business name

PROFILE SHOP, INC.

Doing business as

The Profile Shop

Practice address

3300 Tillman Dr
Suite 105
Bensalem, PA 19020-2071

Phone

(215) 633-3461

Fax

(215) 633-3567

NPI assigned

Aug 2, 2005

Last updated

Mar 27, 2018By 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

Mrs. Heather D. McClure, CMF

Title

Vice President

Phone

(215) 633-3461

Specialties & licenses 1

Addresses

Other names 1

• The Profile Shop Doing business as

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Profile Shop, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Southampton, PA
  • NPI 1982984530
  NPPES parent name

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1205837291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 TILLMAN DR STE 101",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190202071",
            "telephone_number": "215-633-3461",
            "fax_number": "215-633-3567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 TILLMAN DR",
            "address_2": "SUITE 105",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190202071",
            "telephone_number": "215-633-3461",
            "fax_number": "215-633-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFILE SHOP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "MCCLURE",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "215-633-3461",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CMF"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "6000005802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Profile Shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Bensalem, PA
• Providers in Bensalem, 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 Mar 27, 2018; 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.