Provider Demographics
NPI:1699977769
Name:FETA MED, INC.
Entity type:Organization
Organization Name:FETA MED, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:STOCKTON
Authorized Official - Last Name:RUGART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-205-0010
Mailing Address - Street 1:530 S HENDERSON RD STE D
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-4211
Mailing Address - Country:US
Mailing Address - Phone:610-205-0010
Mailing Address - Fax:610-205-0011
Practice Address - Street 1:530 S HENDERSON RD STE D
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-4211
Practice Address - Country:US
Practice Address - Phone:610-205-0010
Practice Address - Fax:610-205-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies