Provider Demographics
NPI:1053414029
Name:TWIN MEDICAL GROUP
Entity type:Organization
Organization Name:TWIN MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:STAUFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-733-3134
Mailing Address - Street 1:344 N READING RD
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-1651
Mailing Address - Country:US
Mailing Address - Phone:717-733-3134
Mailing Address - Fax:717-733-3947
Practice Address - Street 1:344 N READING RD
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1651
Practice Address - Country:US
Practice Address - Phone:717-733-3134
Practice Address - Fax:717-733-3947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies