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General NPI Number Information
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NPI Number | 1689655250
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Entity Type | Organization
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Legal Business Name | SGJ & P INC
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 516B W MAIN ST
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City | SMITHVILLE
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State | TN
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Zip | 37166-1118
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Country | US
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Telephone | 615-597-7822
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Fax | 615-597-1112
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Provider Business Mailing Address
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Address Line | PO BOX 299
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City | SMITHVILLE
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State | TN
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Zip | 37166-0299
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Country | US
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Telephone | 615-597-7822
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Fax | 615-597-1112
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Authorized Official
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Title or Position | OWNER
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Name | SARAH FUSON
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Credential |
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Telephone | 615-597-7822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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