Lab Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LAB MEDICAL LLC

Practice address

105 Montgomery Ave
Suite 1052
Montgomeryville, PA 18936

Phone

(215) 855-1885

Fax

(215) 855-1822

NPI assigned

Mar 18, 2011

Last updated

Mar 24, 2022By 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

Andrew M Deck

Title

President

Phone

(215) 855-1885

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648080000000",
    "number": "1669771465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MONTGOMERY AVE STE 1052",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194461404",
            "telephone_number": "215-855-1885",
            "fax_number": "215-855-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MONTGOMERY AVE",
            "address_2": "SUITE 1052",
            "city": "MONTGOMERYVILLE",
            "state": "PA",
            "postal_code": "18936",
            "telephone_number": "215-855-1885",
            "fax_number": "215-855-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAB MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-18",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "DECK",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-855-1885"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027173300002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Montgomeryville, PA
• Providers in Montgomeryville, 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 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.