Provider Demographics
NPI:1588796528
Name:JEFFREY SCOTT NEELY
Entity Type:Organization
Organization Name:JEFFREY SCOTT NEELY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:NEELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-540-1185
Mailing Address - Street 1:2370 JESSAMY CT
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-6020
Mailing Address - Country:US
Mailing Address - Phone:717-540-1185
Mailing Address - Fax:717-540-5666
Practice Address - Street 1:2370 JESSAMY CT
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-6020
Practice Address - Country:US
Practice Address - Phone:717-540-1185
Practice Address - Fax:717-540-5666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000005728332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4096500001Medicare NSC