Provider Demographics
NPI:1780676965
Name:JOHN LALOR JOYCE INC
Entity Type:Organization
Organization Name:JOHN LALOR JOYCE INC
Other - Org Name:KEYSTONE MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-325-2787
Mailing Address - Street 1:422 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:JIM THORPE
Mailing Address - State:PA
Mailing Address - Zip Code:18229-1406
Mailing Address - Country:US
Mailing Address - Phone:570-325-2787
Mailing Address - Fax:570-325-8795
Practice Address - Street 1:422 CENTER ST
Practice Address - Street 2:
Practice Address - City:JIM THORPE
Practice Address - State:PA
Practice Address - Zip Code:18229-1406
Practice Address - Country:US
Practice Address - Phone:570-325-2787
Practice Address - Fax:570-325-8795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007281830005Medicaid
1018650001Medicare ID - Type Unspecified