Healthcare Provider Details

I. General information

NPI: 1013391150
Provider Name (Legal Business Name): JC BLAIR MEDICAL SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2015
Last Update Date: 02/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7651 LAKE RAYSTOWN SHOPPING CENTER DRIVE
HUNTINGDON PA
16652
US

IV. Provider business mailing address

1225 WARM SPRINGS AVE
HUNTINGDON PA
16652-2350
US

V. Phone/Fax

Practice location:
  • Phone: 814-643-8485
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DEBORAH SHUGHARTS
Title or Position: CFO
Credential:
Phone: 814-643-8445