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ULYSEES GAMMAGE JR NPI 1679691711


NPI Information

NPI: 1679691711
Provider Name: ULYSEES GAMMAGE JR

Doing Business As: UNIVERSALE PEDORTHIC SERVICES

Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
Entity Type: Organization

Specialization: Customized Equipment

Address:
6037 CASTOR AVE
PHILADELPHIA, PA
ZIP 19149
Phone: (215) 776-0981
Get Directions

ULYSEES GAMMAGE JR is a customized equipment durable medical equipment medical supplies in Philadelphia, PA. ULYSEES GAMMAGE JR NPI is 1679691711. The provider is registered as an organization entity type.
The provider Is Doing Business As Universale Pedorthic Services.

The provider's business location address is:

6037 CASTOR AVE
PHILADELPHIA, PA
ZIP 19149-207
Phone: (215) 776-0981
Fax: (215) 224-6611

The provider's authorized official is Ulysees Gammage .
The authorized official title is Owner and has the following contact phone number (215) 776-0981.

The enumeration date for this NPI number is 3/27/2007 and was last updated on 8/4/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332BC3200XDurable Medical Equipment & Medical SuppliesCustomized Equipment6000005706PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14144130001MEDICARE PINPENNSYLVANIA
20005113000OTHERPENNSYLVANIAKEYSTONE EAST
30005113000OTHERPENNSYLVANIADURABLE MEDICAL EQUIPTMEN
44144130001MEDICARE ID-TYPE UNSPECIFIEDPENNSYLVANIADURABLE MEDICAL EQUIPTMEN
50005113000OTHERPENNSYLVANIAPERSONAL CHOICE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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