Provider Demographics
NPI:1316715816
Name:3D MEDICAL DISTRIBUTORS LLC
Entity type:Organization
Organization Name:3D MEDICAL DISTRIBUTORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HATOOKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-378-4122
Mailing Address - Street 1:2316 EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-2510
Mailing Address - Country:US
Mailing Address - Phone:215-378-4122
Mailing Address - Fax:
Practice Address - Street 1:2316 EMERSON ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-2510
Practice Address - Country:US
Practice Address - Phone:215-378-4122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment