Healthcare Provider Details

I. General information

NPI: 1861460909
Provider Name (Legal Business Name): JMAM INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 01/09/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 S HOUCKS RD
HARRISBURG PA
17109-2907
US

IV. Provider business mailing address

265 S HOUCKS RD
HARRISBURG PA
17109-2907
US

V. Phone/Fax

Practice location:
  • Phone: 717-564-7015
  • Fax: 717-564-7189
Mailing address:
  • Phone: 717-564-7015
  • Fax: 717-564-7189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG001471
License Number StatePA

VIII. Authorized Official

Name: DR. JONATHAN ROBERT MURPHY
Title or Position: OWNER
Credential: O.D.
Phone: 717-564-7015