Millbourne Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MILLBOURNE MEDICAL SUPPLY LLC

Practice address

649 Foulkrod St Unit 306
Philadelphia, PA 19120-2125

Phone

(610) 553-7368

NPI assigned

Jan 16, 2023

Organization subpart

No

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

Authorized official

Name

Xiaobin LiNPI 1346225034

Title

Owner

Phone

(215) 813-9430

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Millbourne Medical Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • Upper Darby, PA
  • NPI 1164944641

  8527390251

  Same PAC ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Xiaobin Li, M.D.

  • Internal Medicine Physician
  • Havertown, PA
  • NPI 1346225034
  NPD (past) Authorized official

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1760197610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 FOULKROD ST UNIT 306",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202125",
            "telephone_number": "610-553-7368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 FOULKROD ST UNIT 306",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202125",
            "telephone_number": "610-553-7368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLBOURNE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "XIAOBIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-813-9430"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Regula Milkovitz
• Jerome L. Millan, DMD
• Rowena S Millan
• Allyssa B Millar
• Candice Millard, RD, LDN
• Felina Mille, MD
• Patrick Johnston Mille, M.D.
• Millennium Clinical Services Inc
• Millennium Medical Transportation, Inc
• Michael M Millenson, M.D.

• Durable Medical Equipment & Medical Supplies in Philadelphia, PA
• Providers in Philadelphia, 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 Jan 16, 2023; 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.