Provider Demographics
NPI:1124772231
Name:EUDORA DURABLE MEDICAL EQUIPMENT INC
Entity type:Organization
Organization Name:EUDORA DURABLE MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DME
Authorized Official - Phone:267-330-9648
Mailing Address - Street 1:150 MONUMENT RD STE 207
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1725
Mailing Address - Country:US
Mailing Address - Phone:267-330-9648
Mailing Address - Fax:
Practice Address - Street 1:150 MONUMENT RD
Practice Address - Street 2:SUITE 207
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1725
Practice Address - Country:US
Practice Address - Phone:267-330-9648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies