Provider Demographics
NPI:1568507184
Name:RAYCRAFT & JONES, LLC
Entity type:Organization
Organization Name:RAYCRAFT & JONES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDMUND
Authorized Official - Middle Name:W
Authorized Official - Last Name:RAYCRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:217-875-8100
Mailing Address - Street 1:304 W HAY ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-6328
Mailing Address - Country:US
Mailing Address - Phone:217-875-8100
Mailing Address - Fax:217-872-5486
Practice Address - Street 1:304 W HAY ST
Practice Address - Street 2:SUITE 111
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-6328
Practice Address - Country:US
Practice Address - Phone:217-875-8100
Practice Address - Fax:217-872-5486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5574560001Medicare NSC