Provider Demographics
NPI:1346707734
Name:JEFFERIS MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:JEFFERIS MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFERIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-880-8992
Mailing Address - Street 1:402F GORDON DR
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1249
Mailing Address - Country:US
Mailing Address - Phone:610-880-8992
Mailing Address - Fax:
Practice Address - Street 1:402F GORDON DR
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1249
Practice Address - Country:US
Practice Address - Phone:610-880-8992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies