Provider Demographics
NPI:1982996286
Name:JELS MEDICAL SUPPLIES AND EQUIPMENTS
Entity Type:Organization
Organization Name:JELS MEDICAL SUPPLIES AND EQUIPMENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:SANTOS
Authorized Official - Last Name:SAMPILO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-653-4410
Mailing Address - Street 1:200 BLACKBERRY DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5646
Mailing Address - Country:US
Mailing Address - Phone:301-653-4410
Mailing Address - Fax:
Practice Address - Street 1:200 BLACKBERRY DR
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5646
Practice Address - Country:US
Practice Address - Phone:301-653-4410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies