Provider Demographics
NPI:1326547589
Name:JMDLAD INC.
Entity Type:Organization
Organization Name:JMDLAD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OBERHOLTZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-632-5558
Mailing Address - Street 1:600 CARLISLE ST STE A
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-5100
Mailing Address - Country:US
Mailing Address - Phone:717-632-5558
Mailing Address - Fax:
Practice Address - Street 1:600 CARLISLE ST STE A
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-5100
Practice Address - Country:US
Practice Address - Phone:717-632-5558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-02
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADO1044261QH0700X, 332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech