West Side Medical

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

5563260001 Issued in PA

Legal business name

WEST SIDE MEDICAL

Practice address

62 W End Rd
Hanover Township, PA 18706-5425

Phone

(570) 704-4614

Fax

(570) 704-4613

NPI assigned

May 30, 2007

Organization subpart

No

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

Authorized official

Name

Mr. James Michael Hudak

Title

President

Phone

(570) 704-4616

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262217600000",
    "number": "1295936938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 W END RD",
            "city": "HANOVER TOWNSHIP",
            "state": "PA",
            "postal_code": "187065425",
            "telephone_number": "570-704-4614",
            "fax_number": "570-704-4613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 W END RD",
            "city": "HANOVER TOWNSHIP",
            "state": "PA",
            "postal_code": "187065425",
            "telephone_number": "570-704-4614",
            "fax_number": "570-704-4613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SIDE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2009-12-31",
        "status": "A",
        "authorized_official_last_name": "HUDAK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-704-4616",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "5563260001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Hanover Township, PA
• Providers in Hanover Township, 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 Dec 31, 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.