Provider Demographics
NPI:1538425889
Name:JIRETH MEDICAL SUPPLY COMPANY, INC
Entity type:Organization
Organization Name:JIRETH MEDICAL SUPPLY COMPANY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-280-6714
Mailing Address - Street 1:8 MUSICMASTER CT
Mailing Address - Street 2:132
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-6847
Mailing Address - Country:US
Mailing Address - Phone:240-280-6714
Mailing Address - Fax:877-421-9896
Practice Address - Street 1:8 MUSICMASTER CT
Practice Address - Street 2:132
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904
Practice Address - Country:US
Practice Address - Phone:240-280-6714
Practice Address - Fax:877-421-9896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies