Provider Demographics
NPI:1649331570
Name:COONEY MEDICAL INC.
Entity type:Organization
Organization Name:COONEY MEDICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOWEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-876-5252
Mailing Address - Street 1:633 SCRANTON CARBONDALE HWY
Mailing Address - Street 2:
Mailing Address - City:EYNON
Mailing Address - State:PA
Mailing Address - Zip Code:18403-1022
Mailing Address - Country:US
Mailing Address - Phone:570-876-5252
Mailing Address - Fax:570-876-4611
Practice Address - Street 1:633 SCRANTON CARBONDALE HWY
Practice Address - Street 2:
Practice Address - City:EYNON
Practice Address - State:PA
Practice Address - Zip Code:18403-1022
Practice Address - Country:US
Practice Address - Phone:570-876-5252
Practice Address - Fax:570-876-4671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000005501332BP3500X, 332BX2000X, 335E00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAN290772OtherWELLCARE HEALTH PLAN NO
PA000202391OtherBLUE CROSS BLUE SHIELD NO
PA048870400OtherFEDERAL BLACK LUNG NO
PA0075870390003Medicaid
PA1312110001OtherSTERLING OPTIONS PLAN 1
PA048870400OtherFEDERAL BLACK LUNG NO
PA0075870390003Medicaid