Provider Demographics
NPI:1699103820
Name:MCPHERSON PEST CONTROL
Entity type:Organization
Organization Name:MCPHERSON PEST CONTROL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:MCPHERSON
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:850-593-5674
Mailing Address - Street 1:7979A SHADY GROVE ROAD
Mailing Address - Street 2:
Mailing Address - City:GRAND RIDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32442
Mailing Address - Country:US
Mailing Address - Phone:850-593-5674
Mailing Address - Fax:850-593-0583
Practice Address - Street 1:7979A SHADY GROVE ROAD
Practice Address - Street 2:
Practice Address - City:GRAND RIDGE
Practice Address - State:FL
Practice Address - Zip Code:32442-3815
Practice Address - Country:US
Practice Address - Phone:850-593-5674
Practice Address - Fax:850-593-0583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-25
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLJB122390332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals