Individual ProviderLuan PhamFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address740 High St, Suite 4001, Williamsport, PA 17701-3100(570) 321-2345PECOS EnrollmentBased on the most recent information from CMS, provider Luan Pham is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1558526665Provider TypeIndividualFull NamePham, LuanTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date7/29/2008Last Updated8/4/2021Contact InformationPractice LocationPractice Address740 High St, Suite 4001, Williamsport, PA 17701-3100Phone(570) 321-2345Fax(570) 321-2359Mailing LocationMailing Address1201 Grampian Blvd, Williamsport, PA 17701-1900PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseMD441569Pennsylvania