Provider Demographics
NPI:1760025704
Name:JONES, EDDIE DELANO SR
Entity Type:Individual
Prefix:MR
First Name:EDDIE
Middle Name:DELANO
Last Name:JONES
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7364 WOODSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-9135
Mailing Address - Country:US
Mailing Address - Phone:909-461-7801
Mailing Address - Fax:
Practice Address - Street 1:7364 WOODSHIRE LN
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-9135
Practice Address - Country:US
Practice Address - Phone:909-461-7801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)