Basic Information
Provider Information
NPI: 1154743631
EntityType: 2
ReplacementNPI:  
OrganizationName: TRICOUNTY MEDICAL EQUIPMENT AND SUPPLY, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: YOUNG'S MEDICAL EQUIPMENT
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 220 W GERMANTOWN PIKE STE 250
Address2:  
City: PLYMOUTH MEETING
State: PA
PostalCode: 194621437
CountryCode: US
TelephoneNumber: 6106306357
FaxNumber:  
Practice Location
Address1: 519 E MARKET ST STE 120
Address2:  
City: DANVILLE
State: PA
PostalCode: 178212009
CountryCode: US
TelephoneNumber: 8009996504
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/17/2014
LastUpdateDate: 03/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: GRIGGS
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 4072060040
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  N SuppliersDurable Medical Equipment & Medical Supplies 
332BX2000X  Y SuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies

No ID Information.


Home