Provider Demographics
NPI:1588989255
Name:MEDEAST POST-OP & SURGICAL, INC.
Entity type:Organization
Organization Name:MEDEAST POST-OP & SURGICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOTIST
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-433-1073
Mailing Address - Street 1:496 KINGS HWY N STE 130
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1015
Mailing Address - Country:US
Mailing Address - Phone:856-829-2030
Mailing Address - Fax:267-299-9001
Practice Address - Street 1:496 KINGS HWY N STE 130
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1015
Practice Address - Country:US
Practice Address - Phone:856-829-2030
Practice Address - Fax:267-299-9001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJA08010870OtherMEDICARE EDI SUBMITTER #
NJ=========OtherHORIZON
NJA08010870OtherMEDICARE EDI SUBMITTER #
NJ=========OtherTAX ID #
NJ4781000002Medicare NSC