Organization Name: | PERFORMANCE BIOMEDICAL LLC |
NPI Number: | 1770875197 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RONALD CHRISTOPHER CARTER (CEO) |
Mailing Address: | 359 S Mountain Blvd Suite C3 Mountain Top |
State: | PA US |
Postal Code: | 187071984 |
Phone Number: | 8885063770 |
Fax Number: | 8886880403 |
NPI Enumeration Date: | 05/03/2011 |
NPI Last Update Date: | 08/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |