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Mr. John Marshall Provost, CPED
Durable Medical Equipment & Medical Supplies in Hazleton, Pennsylvania
NPI 1992821920

John Marshall Provost is a Durable Medical Equipment & Medical Supplies based in W Hazleton, PA. John Marshall Provost practices in Hazleton, PA and has the professional credentials of CPED. The NPI Number for John Marshall Provost is 1992821920 and holds a License No. 4244780002 (Pennsylvania).

The current practice location address for John Marshall Provost is 25 Laurel Mall, Hazleton, PA and can be reached out via phone at 570-455-7704 and via fax at 570-455-7704.

Location: 25 Laurel Mall, Hazleton, PA, 18202-3615
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1992821920
Provider Name
John Marshall Provost
Credential
CPED
Provider Entity Type
Individual
Gender
Male
Address
25 Laurel Mall, Hazleton, PA, 18202-3615
Phone Number
570-455-7704
Fax Number
570-455-7704
Provider Enumeration Date
03/21/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
A08009797 01 PA MEDICARE EDI BILLING NUMB
institution
Provider Business Practice Location Address Details
Address
25 Laurel Mall
City
Hazleton
State
Pennsylvania
Zip
18202-1201
Phone Number
570-455-7704
Fax Number
570-455-7704
person
Provider Business Mailing Address Details
Address
25 Laurel Mall
City
Hazleton
State
Pennsylvania
Zip
18202-1201
Phone Number
570-455-7704
Fax Number
570-455-7704
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
4244780002 (Pennsylvania)
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
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