Provider Demographics
NPI:1134454242
Name:JERSEY TENS MEDICAL SUPPLIER, LLC
Entity type:Organization
Organization Name:JERSEY TENS MEDICAL SUPPLIER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:FEIJO-MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-623-7400
Mailing Address - Street 1:PO BOX 453
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008-0453
Mailing Address - Country:US
Mailing Address - Phone:973-623-7400
Mailing Address - Fax:973-623-7800
Practice Address - Street 1:61 HEALD ST
Practice Address - Street 2:
Practice Address - City:CARTERET
Practice Address - State:NJ
Practice Address - Zip Code:07008-2711
Practice Address - Country:US
Practice Address - Phone:973-623-7400
Practice Address - Fax:973-623-7800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies