Provider Demographics
NPI:1053629717
Name:SECOND HANDS LLC
Entity Type:Organization
Organization Name:SECOND HANDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JOHNNIE
Authorized Official - Middle Name:DANNETT
Authorized Official - Last Name:JETER
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL HEALTH TECH
Authorized Official - Phone:216-371-3979
Mailing Address - Street 1:2113 LEE BLVD
Mailing Address - Street 2:EAST CLEVELAND
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-4024
Mailing Address - Country:US
Mailing Address - Phone:216-371-3979
Mailing Address - Fax:
Practice Address - Street 1:2113 LEE BLVD
Practice Address - Street 2:EAST CLEVELAND
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-4024
Practice Address - Country:US
Practice Address - Phone:216-371-3979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health