Provider Demographics
NPI:1437176195
Name:JEFF QUIP, INC.
Entity Type:Organization
Organization Name:JEFF QUIP, INC.
Other - Org Name:THE HOME CARE NETWORK, JEFFERSON HEALTH SYSTEM - REHAB EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RIICHARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:JACOVINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-580-1400
Mailing Address - Street 1:12 CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:BOOTHWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19061-3132
Mailing Address - Country:US
Mailing Address - Phone:610-586-6072
Mailing Address - Fax:610-586-4742
Practice Address - Street 1:12 CREEK PKWY
Practice Address - Street 2:
Practice Address - City:BOOTHWYN
Practice Address - State:PA
Practice Address - Zip Code:19061-3132
Practice Address - Country:US
Practice Address - Phone:610-586-6072
Practice Address - Fax:610-586-4742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA700003332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007409830007Medicaid
PA1007409830007Medicaid