Provider Demographics
NPI:1306829197
Name:J & L MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:J & L MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:LOYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-757-4991
Mailing Address - Street 1:199 PARK ROAD EXT
Mailing Address - Street 2:PO BOX 1437
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1832
Mailing Address - Country:US
Mailing Address - Phone:203-757-4991
Mailing Address - Fax:203-757-9935
Practice Address - Street 1:199 PARK ROAD EXT
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-1832
Practice Address - Country:US
Practice Address - Phone:203-757-4991
Practice Address - Fax:203-757-9935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-25
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004228236Medicaid
CT004228236Medicaid