JETHRO MEDICAL, LLC (NPI# 1366855025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366855025 |
| Entity Type | Organization |
| Organization Name | JETHRO MEDICAL, LLC |
| Practice Address |
2142 N Fine Ave Fresno CA 93727-1513 |
| Mailing Address |
2142 N. Fine Ave. Fresno CA 93727-1513 |
| Practice Telephone | 5593073342 |
| Practice Fax Number | 5594944900 |
| Mailing Telephone | 5594944900 |
| Mailing Fax Number | 5594944900 |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2014-10-28 |
| Authorized Official Name | MICHAEL BERNARDONI (PRESIDENT) |
| Authorized Official Telephone | 5594944900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
Suppliers | ||
| Y | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
Suppliers |
| Street Address |
2142 N FINE AVE |
| City | FRESNO |
| State | CA |
| Zip Code | 93727-1513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427524354 | Travis L Minor | Driver | 4573 Kings Canyon Rd, Freso, CA 93727 | 2018-10-18 |
| 1780178921 | Amanda Hernandez | Behavior Technician | 6358 E Mono St, Fresno, CA 93727 | 2018-06-20 |
| 1225533169 | Lindsay Fisher | Marriage & Family Therapist | 4928 E Clinton Way Ste 108, Fresno, CA 93727 | 2018-03-23 |
| 1811351992 | Paulinder Ranu | Pediatrics | 5557 E King Cyn Rd, Fresno, CA 93727 | 2016-04-05 |
| 1851781371 | Sheri Taylor | Social Worker | 2010 N Fine Ave # 105, Fresno, CA 93727 | 2015-02-04 |
| 1770917486 | Elouise Jones-green | Counselor | 4491 E. Mckinley Ave #112, Fresno, CA 93727 | 2013-08-29 |
| 1700227022 | Chee Vang | Counselor | 4855 E Kings Canyon Rd Ste 105, Fresno, CA 93727 | 2013-07-15 |
| 1578839791 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 5995 E Kings Canyon Rd, Fresno, CA 93727 | 2012-04-02 |
| 1932411378 | Leticia Ball | Marriage & Family Therapist | 4944 E. Clinton Way, Fresno, CA 93727 | 2010-07-13 |
| 1639308158 | Juanita Sermeno | Counselor | 4944 E. Clinton, Suite 101, Fresno, CA 93727 | 2009-07-06 |
| Find all providers in zip 93727 | ||||
| Taxonomy Code | 332BN1400X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Nursing Facility Supplies |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588113088 | Gkn Rx | Durable Medical Equipment & Medical Supplies | 7072 N Cedar Ave, Fresno, CA 93720-3300 | 2016-09-26 |
| 1639178767 | Hope Manor, Inc. | Durable Medical Equipment & Medical Supplies | 1665 M Street, Fresno, CA 93721 | 2005-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1285279083 | Danny F. San Miguel | Durable Medical Equipment & Medical Supplies | 9607 Business Center Dr Unit E, Rancho Cucamonga, CA 91730-4557 | 2019-11-15 |
| 1558826628 | Sml Medical Supplies, Inc. | Durable Medical Equipment & Medical Supplies | 22345 La Palma Ave Ste 101-102, Yorba Linda, CA 92887-3822 | 2019-02-04 |
| 1346724432 | Verio Healthcare, Inc | Durable Medical Equipment & Medical Supplies | 26855 Jefferson Ave Ste C, Murrieta, CA 92562-8966 | 2018-09-24 |
| 1770072712 | Conversions Technology LLC | Durable Medical Equipment & Medical Supplies | 2962 Seaborg Ave, Ventura, CA 93003-7643 | 2018-05-04 |
| 1730698077 | Verio Healthcare, Inc | Durable Medical Equipment & Medical Supplies | 11805 Smith Ave, Santa Fe Springs, CA 90670-3226 | 2017-09-28 |
| 1407202120 | Fleximug LLC | Durable Medical Equipment & Medical Supplies | 1041 Market St # 400, San Diego, CA 92101-7233 | 2016-05-12 |
| 1760836837 | Verio Healthcare | Durable Medical Equipment & Medical Supplies | 1850 W Main St Ste B, El Centro, CA 92243-2106 | 2016-04-14 |
| 1477928836 | Avenue Medical Equipment | Durable Medical Equipment & Medical Supplies | 3142 Tiger Run Ct, Suite 118, Carlsbad, CA 92010-6692 | 2015-12-09 |
| 1801284732 | Wound Care Solutions | Durable Medical Equipment & Medical Supplies | 8671 Tommy Dr, San Diego, CA 92119-2011 | 2014-12-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.