Provider Demographics
NPI:1033735071
Name:PROVISION POINT LLC
Entity type:Organization
Organization Name:PROVISION POINT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DME
Authorized Official - Phone:215-207-1073
Mailing Address - Street 1:2560 BELMONT AVE APT 206B
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131
Mailing Address - Country:US
Mailing Address - Phone:215-207-1073
Mailing Address - Fax:
Practice Address - Street 1:2560 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131
Practice Address - Country:US
Practice Address - Phone:215-207-1073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEBRINA CRUSE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies