Active NPI
Golden Brace Medical Supplied LTD
- Customized Equipment (DME)
- Philadelphia, PA
National Provider Identifier
1629831722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Customized Equipment (DME)
- Legal business name
- GOLDEN BRACE MEDICAL SUPPLIED LTD
- Practice address
- 5922 N Broad St
Philadelphia, PA 19141-1851 - Phone
- (267) 368-1011
- NPI assigned
- Feb 1, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Keith George, PHD
- Title
- Ceo
- Phone
- (267) 368-1011
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Customized Equipment (DME) | 332BC3200X | Primary | ||
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X |
Addresses
Primary practice location
5922 N Broad St
Philadelphia, PA 19141-1851
Mailing address
2210 Michener St
Philadelphia, PA 19115-4320
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706745600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1706745600000",
"number": "1629831722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2210 MICHENER ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191154320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5922 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191411851",
"telephone_number": "267-368-1011"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOLDEN BRACE MEDICAL SUPPLIED LTD",
"organizational_subpart": "NO",
"enumeration_date": "2024-02-01",
"last_updated": "2024-02-01",
"certification_date": "2024-02-01",
"status": "A",
"authorized_official_last_name": "GEORGE",
"authorized_official_first_name": "KEITH",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "267-368-1011",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": null,
"license": null,
"primary": true
},
{
"code": "332BP3500X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.