Organization Name: | MICHELE Y SHADE, O.D. |
NPI Number: | 1073781696 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHELE SHADE (PROPRIETOR) |
Mailing Address: | 142 Shoemaker Rd Pottstown |
State: | PA US |
Postal Code: | 194646430 |
Phone Number: | 6103261106 |
Fax Number: | 6103261108 |
NPI Enumeration Date: | 02/16/2008 |
NPI Last Update Date: | 07/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | OEG000169 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |