Provider Demographics
NPI:1154405348
Name:EM MEDICAL INC
Entity type:Organization
Organization Name:EM MEDICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MIHALEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-746-3357
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:WYALUSING
Mailing Address - State:PA
Mailing Address - Zip Code:18853-0037
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:STATE ROUTE 6
Practice Address - Street 2:
Practice Address - City:WYALUSING
Practice Address - State:PA
Practice Address - Zip Code:18853-0037
Practice Address - Country:US
Practice Address - Phone:570-746-3357
Practice Address - Fax:570-746-3839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0003X
PAPP414254L333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3959321OtherOTHER ID NUMBER-COMMERCIAL NUMBER
PA1007607070001Medicaid
3959321OtherOTHER ID NUMBER
3959321OtherOTHER ID NUMBER-COMMERCIAL NUMBER