Provider Demographics
NPI:1366140469
Name:JFM SAL LLC
Entity type:Organization
Organization Name:JFM SAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LEPPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-242-6341
Mailing Address - Street 1:117 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-2903
Mailing Address - Country:US
Mailing Address - Phone:217-223-8791
Mailing Address - Fax:217-223-8791
Practice Address - Street 1:117 N 6TH ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-2903
Practice Address - Country:US
Practice Address - Phone:217-223-8791
Practice Address - Fax:217-223-8791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-17
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy FitterGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic Supplier