Provider Demographics
NPI:1134625767
Name:JLR PC ADAM ASSOCIATES
Entity type:Organization
Organization Name:JLR PC ADAM ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:724-297-3446
Mailing Address - Street 1:15141 US ROUTE 422
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16262-2501
Mailing Address - Country:US
Mailing Address - Phone:724-297-3446
Mailing Address - Fax:
Practice Address - Street 1:15141 US ROUTE 422
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:PA
Practice Address - Zip Code:16262-2501
Practice Address - Country:US
Practice Address - Phone:724-297-3446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment