NPIMap

Organization Active NPI

Pro Medical East LLC

  • Durable Medical Equipment & Medical Supplies
  • Garnet Valley, PA
National Provider Identifier
1841291200
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PRO MEDICAL EAST LLC
Practice address
1440 Conchester Hwy Unit B2
Garnet Valley, PA 19060-2124
Phone
(732) 657-9600
Fax
(732) 657-9400
NPI assigned
Aug 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Authorized official

Name
Patricia Ann Moody
Title
Business Admin
Phone
(732) 348-0103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1440 Conchester Hwy Unit B2
Garnet Valley, PA 19060-2124

Mailing address

1950 Rutgers University Blvd
Lakewood, NJ 08701-4537
Phone (732) 657-9600

Other identifiers 23

IdentifierTypeStateIssuer
000246014OtherPAHIGHMARK BC
226221OtherPAADVANTRA CARELINK
625683800MedicaidMO
90171OtherMNMINN BC/BS
629315OtherVAANTHEM BC OF VIRGINIA
P2723785OtherPAAETNA
1861130MedicaidPA
642648400MedicaidMN
8200594OtherEVERCARE
90003799MedicaidKY
4344350MedicaidMI
54432383MedicaidCO
DM1174MedicaidSC
010145988MedicaidVA
246014OtherHIGHMARK BC/BS
41731600MedicaidWI
5164OtherNJAMERIHEALTH
8704805MedicaidNJ
0005164000OtherPAIBX
1163297OtherMOMERCY HEALTH PLANS - MO
2272955MedicaidOH
540H104220OtherMIMICHIGAN BC/BS
P2723785OtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930054588 PA DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Orthotic PersonnelDME Supplier - Pedorthic PersonnelDME Supplier - Medical Supply Company With Pedorthic Personnel 7517179625 Practice locations: Garnet Valley, PA

Other NPIs with the same Medicare PAC ID 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Pro Medical East1440 Conchester Hwy, Garnet Valley, PA 19060-2124(732) 657-9600 Commodes, Urinals, Bedpans|Contracture Treatment Devices: Dynamic Splint|Heat & Cold Applications|Pneumatic Compression Devices and/or Supplies|Traction Equipment|(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies|Canes and/or Crutches|Patient Lifts|Power Operated Vehicles (Scooters… Accepts assignmentParticipating since Jan 1, 2002

National Provider Directory

National Provider Directory
Tax ID family
Healthcare Partners LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1995 Rutgers Blvd
Lakewood, NJ 08701

1440 Conchester Hwy
#B2
Garnet Valley, PA 19060

1440 Conchester Hwy
Unit B2
Garnet Valley, PA 19060
Phone (732) 657-9600

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1841291200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 RUTGERS UNIVERSITY BLVD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014537",
            "telephone_number": "732-657-9600",
            "fax_number": "732-657-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 CONCHESTER HWY UNIT B2",
            "city": "GARNET VALLEY",
            "state": "PA",
            "postal_code": "190602124",
            "telephone_number": "732-657-9600",
            "fax_number": "732-657-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO MEDICAL EAST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "BUSINESS ADMIN",
        "authorized_official_telephone_number": "732-348-0103"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC",
            "identifier": "000246014",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANTRA CARELINK",
            "identifier": "226221",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "625683800",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINN BC/BS",
            "identifier": "90171",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC OF VIRGINIA",
            "identifier": "629315",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "P2723785",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861130",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "642648400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "8200594",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90003799",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4344350",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54432383",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DM1174",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010145988",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC/BS",
            "identifier": "246014",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41731600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "5164",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8704805",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBX",
            "identifier": "0005164000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLANS - MO",
            "identifier": "1163297",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2272955",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN BC/BS",
            "identifier": "540H104220",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "P2723785",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garnet Valley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.