Provider Demographics
NPI:1548589641
Name:PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES, LTD
Entity type:Organization
Organization Name:PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MALUMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-359-5672
Mailing Address - Street 1:PO BOX 34490
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0622
Mailing Address - Country:US
Mailing Address - Phone:610-359-5672
Mailing Address - Fax:610-449-9814
Practice Address - Street 1:510 W DARBY RD
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-4639
Practice Address - Country:US
Practice Address - Phone:610-449-6499
Practice Address - Fax:610-449-9814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-28
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4220790006Medicare NSC