1003331737 NPI number — ACCESSIBLE SERVICES AND PRODUCTS, LLC

Table of content: JITENDER KUMAR JAIN M.D. (NPI 1598784100)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003331737 NPI number — ACCESSIBLE SERVICES AND PRODUCTS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCESSIBLE SERVICES AND PRODUCTS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
R M PENYAK & CO INC
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003331737
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2135 BUSTARD RD STE 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANSDALE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19446-5724
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-473-6925
Provider Business Mailing Address Fax Number:
610-584-9767

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2135 BUSTARD RD STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANSDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19446-5724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-473-6925
Provider Business Practice Location Address Fax Number:
610-584-9767
Provider Enumeration Date:
08/03/2017

Additional Information

Authorized Official

Authorized Official Last Name:
PENYAK
Authorized Official First Name:
RAYMOND
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
610-584-9629

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  6000003509 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0018511060001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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