Provider Demographics
NPI:1740419928
Name:JERRY HATCH
Entity Type:Organization
Organization Name:JERRY HATCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-733-2484
Mailing Address - Street 1:1989 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:TRESCOTT TWP
Mailing Address - State:ME
Mailing Address - Zip Code:04652-5112
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1989 COUNTY RD
Practice Address - Street 2:
Practice Address - City:TRESCOTT TWP
Practice Address - State:ME
Practice Address - Zip Code:04652-5112
Practice Address - Country:US
Practice Address - Phone:207-733-2484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care