MR. JOHN MARSHALL PROVOST (NPI# 1992821920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992821920 |
| Entity Type | Individual |
| Full Name | MR. JOHN MARSHALL PROVOST |
| Credential | C.PED |
| Practice Address |
25 Laurel Mall Provost Shoes Hazleton PA 18202-1201 |
| Mailing Address |
732 North St W Hazleton PA 18202-3615 |
| Practice Telephone | 5704557704 |
| Practice Fax Number | 5704557704 |
| Mailing Telephone | 5704557704 |
| Mailing Fax Number | 5704546324 |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 4244780002 | PA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | MEDICARE EDI BILLING NUMB | A08009797 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023129947 | John Francis Provost | Social Worker | 750 Veterans Highway, Suite 205, Hauppauge, NY 11788-2943 | 2006-08-31 |
| Street Address |
25 LAUREL MALL PROVOST SHOES |
| City | HAZLETON |
| State | PA |
| Zip Code | 18202-1201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447431945 | Provost Shoes | Durable Medical Equipment & Medical Supplies | 25 Laurel Mall, Hazleton, PA 18202-1201 | 2007-11-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013428184 | Patch Town Emergency Physicians LLC | Emergency Medicine | 26 Station Circle, Hazleton, PA 18202 | 2017-10-17 |
| 1770015653 | Lauren Sanzi | Chiropractor | 426 Airport Beltway, 132a, Hazle Township, PA 18202 | 2017-03-30 |
| 1770913667 | Marian Filkins | Physical Therapy Assistant | 401-403 Hazle Township Blvd, Hazle Township, PA 18202 | 2013-11-14 |
| 1528305851 | Christian John Fink | Registered Nurse | 405 Winters Ave, West Hazleton, PA 18202 | 2013-01-07 |
| 1952639601 | Kathleen S. Veglia, M.d. | Pathology | 1525 N. Churct St., Hazle Township, PA 18202 | 2009-11-18 |
| 1407182447 | Sarah Marie Magula | Registered Nurse | 6 Diana Ln, West Hazleton, PA 18202 | 2009-10-27 |
| 1932354669 | Robert W. Zukoski | Technician/Technologist | 1097 No. Church St., Hazelton, PA 18202 | 2008-11-21 |
| 1699947085 | Dr Sandra M Krokos & Thomas P Kislan PC | Optometrist | 281 Airport Road, Hazle Township, PA 18202 | 2008-03-26 |
| 1952478349 | Joseph Serafin Pelly | Dentist | 20 East Broad St, West Hazelton, PA 18202 | 2006-11-29 |
| 1659457158 | Derek Enterprises | Physical Therapist | 106 Rotary Drive, Valmont Industrial Park, W Hazleton, PA 18202 | 2006-10-27 |
| Find all providers in zip 18202 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851480511 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 1000 North Church Street, Hazleton, PA 18201-5804 | 2006-10-12 |
| 1245212257 | Luzerne Medical Inc | Durable Medical Equipment & Medical Supplies | 92 N Wyoming St, Hazleton, PA 18201-6028 | 2005-11-16 |
| 1447431945 | Provost Shoes | Durable Medical Equipment & Medical Supplies | 25 Laurel Mall, Hazleton, PA 18202-1201 | 2007-11-26 |
| 1740320282 | Yocums Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 1749 E Broad St, Hazleton, PA 18201 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477066 | All American Sleep Alternatives LLC | Durable Medical Equipment & Medical Supplies | 7 N Morgantown St, Fairchance, PA 15436-1180 | 2020-11-03 |
| 1487254967 | Gvm-us Inc. | Durable Medical Equipment & Medical Supplies | 274 Milton Dr, Malvern, PA 19355-8760 | 2020-10-26 |
| 1043819287 | Flores Medical Supplies | Durable Medical Equipment & Medical Supplies | 465 Pike Rd Ste 113, Huntingdon Valley, PA 19006-1622 | 2020-10-19 |
| 1174121982 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 807 Lawn Ave Ste 104, Sellersville, PA 18960-1549 | 2020-10-14 |
| 1275131476 | Igor Pavlo | Durable Medical Equipment & Medical Supplies | 2399 S Whittmore St, Furlong, PA 18925-1549 | 2020-10-12 |
| 1306443502 | Ati Holding LLC | Durable Medical Equipment & Medical Supplies | 5038 Pennell Rd, Aston, PA 19014-1868 | 2020-10-01 |
| 1912511270 | Aspire Home Care Services LLC | Durable Medical Equipment & Medical Supplies | 295 Wyoming Ave Suite 2f, Wyoming, PA 18644-0274 | 2020-09-03 |
| 1710590534 | Restorative Medical Equipment and Supplies | Durable Medical Equipment & Medical Supplies | 1516 N 5th St Unit 327, Philadelphia, PA 19122-3679 | 2020-08-31 |
| 1982217253 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 245 W Race St Ste 115, Somerset, PA 15501-1922 | 2020-08-26 |
| 1609488485 | Rayaan Dhungel | Durable Medical Equipment & Medical Supplies | 814 Green Ridge St, Scranton, PA 18509-1908 | 2020-08-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.