Provider Demographics
NPI:1467924605
Name:SJ KOBERS
Entity Type:Organization
Organization Name:SJ KOBERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEREE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-466-5858
Mailing Address - Street 1:114 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-1982
Mailing Address - Country:US
Mailing Address - Phone:717-466-5858
Mailing Address - Fax:
Practice Address - Street 1:114 W MAIN ST
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1982
Practice Address - Country:US
Practice Address - Phone:717-466-5858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6616454OtherENTITYNUMBER