Provider Demographics
NPI:1386792695
Name:S & J SCOOTER SUPPLY
Entity type:Organization
Organization Name:S & J SCOOTER SUPPLY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:SAMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-351-1111
Mailing Address - Street 1:1058 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-3366
Mailing Address - Country:US
Mailing Address - Phone:630-351-1111
Mailing Address - Fax:630-351-8828
Practice Address - Street 1:1058 LAKE ST
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172-3366
Practice Address - Country:US
Practice Address - Phone:630-351-1111
Practice Address - Fax:630-351-8828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment