Healthcare Provider Details

I. General information

NPI: 1104942853
Provider Name (Legal Business Name): JOSEPH L SIMMONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3534 KUTZTOWN ROAD
LAURELDALE PA
19605-1853
US

IV. Provider business mailing address

3534 KUTZTOWN ROAD
LAURELDALE PA
19605-1853
US

V. Phone/Fax

Practice location:
  • Phone: 610-921-1636
  • Fax: 610-921-1637
Mailing address:
  • Phone: 610-921-1636
  • Fax: 610-921-1637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberD00101
License Number StatePA

VIII. Authorized Official

Name: MR. JOHN DAVID SIMMONS
Title or Position: PRESIDENT DISPENSER
Credential: STATE LICENSE F2067
Phone: 610-921-1636