MEDICARE: JEFFS SURGICAL SUPPLY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629071535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFS SURGICAL SUPPLY INC.

Provider Business Mailing Address
First Line	:	2249 WOODBRIDGE AVE
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-5554
Country	:	US
Telephone Number	:	732-985-5333
Fax Number	:	732-985-8660

Provider Business Practice Location Address
First Line	:	2249 WOODBRIDGE AVE
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-5554
Country	:	US
Telephone Number	:	732-985-5333
Fax Number	:	732-985-8660

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JEFFREY ACKERMAN
Credential	:
Telephone Number	:	732-985-5333

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	09/04/2007

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