Provider Demographics
NPI:1528319340
Name:J & J TURF SUPPLY INC.
Entity type:Organization
Organization Name:J & J TURF SUPPLY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:E
Authorized Official - Last Name:FREED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-346-6107
Mailing Address - Street 1:4911 LYONS TECHNOLOGY PKWY
Mailing Address - Street 2:# 7
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4347
Mailing Address - Country:US
Mailing Address - Phone:954-419-1390
Mailing Address - Fax:
Practice Address - Street 1:4911 LYONS TECHNOLOGY PKWY
Practice Address - Street 2:# 7
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4347
Practice Address - Country:US
Practice Address - Phone:954-419-1390
Practice Address - Fax:954-419-1390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH242533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy