Provider Demographics
NPI:1699773382
Name:TALC CORP
Entity type:Organization
Organization Name:TALC CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:T
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-884-2990
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-0249
Mailing Address - Country:US
Mailing Address - Phone:215-887-4577
Mailing Address - Fax:215-887-4505
Practice Address - Street 1:108 110 S. EASTON RD.
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-0249
Practice Address - Country:US
Practice Address - Phone:215-887-4577
Practice Address - Fax:215-887-4505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA332BX2000X
PAPP41284673336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0564220Medicaid
PA91931OtherAETNA
PA0573000001Medicare NSC