Provider Demographics
NPI:1689988214
Name:JPV SALES INC
Entity Type:Organization
Organization Name:JPV SALES INC
Other - Org Name:COMFORT KEEPERS #358
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:VITO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:570-307-0414
Mailing Address - Street 1:412 LACKAWANNA AVE
Mailing Address - Street 2:
Mailing Address - City:OLYPHANT
Mailing Address - State:PA
Mailing Address - Zip Code:18447-1524
Mailing Address - Country:US
Mailing Address - Phone:570-307-0414
Mailing Address - Fax:570-307-0422
Practice Address - Street 1:412 LACKAWANNA AVE
Practice Address - Street 2:
Practice Address - City:OLYPHANT
Practice Address - State:PA
Practice Address - Zip Code:18447-1524
Practice Address - Country:US
Practice Address - Phone:570-307-0414
Practice Address - Fax:570-307-0422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA10233601251S00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023861480013Medicaid