NPIMap

Organization Active NPI

At Medical DME

  • Prosthetic/Orthotic Supplier
  • Bala Cynwyd, PA
National Provider Identifier
1245779180
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
OH000301 Issued in PA
Legal business name
AT MEDICAL DME
Practice address
45 E City Line Ave
PMB 535
Bala Cynwyd, PA 19004-2421
Phone
(610) 724-3561
NPI assigned
Feb 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Authorized official

Name
Mr. Michael Keith Keene Jr., BOCO
Title
Consultant
Phone
(610) 724-3561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X OH000301 PA Primary

Addresses

Primary practice location

45 E City Line Ave
PMB 535
Bala Cynwyd, PA 19004-2421

Mailing address

45 E City Line Ave
PMB 535
Bala Cynwyd, PA 19004-2421
Phone (610) 724-3561

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1245779180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 E CITY LINE AVE",
            "address_2": "PMB 535",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190042421",
            "telephone_number": "610-724-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 E CITY LINE AVE",
            "address_2": "PMB 535",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190042421",
            "telephone_number": "610-724-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AT MEDICAL DME",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "KEENE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "610-724-3561",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "BOCO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "PA",
            "license": "OH000301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.