Provider Demographics
NPI:1174071823
Name:PREMIER ORTHOPAEDIC & SPORTS MEDICINE ASSO., LTD.
Entity type:Organization
Organization Name:PREMIER ORTHOPAEDIC & SPORTS MEDICINE ASSO., LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MALUMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-359-5660
Mailing Address - Street 1:PO BOX 5228
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-0405
Mailing Address - Country:US
Mailing Address - Phone:610-359-5640
Mailing Address - Fax:610-359-1519
Practice Address - Street 1:2004 FOULK RD
Practice Address - Street 2:SUITE 3
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3641
Practice Address - Country:US
Practice Address - Phone:610-876-0347
Practice Address - Fax:610-876-4789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-12
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE220044Medicare PIN