Jethro Medical, LLC

Primary specialty

Nursing Facility Supplies (DME)Taxonomy code 332BN1400X

Legal business name

JETHRO MEDICAL, LLC

Practice address

2142 N Fine Ave
Fresno, CA 93727-1513

Phone

(559) 307-3342

Fax

(559) 494-4900

NPI assigned

Jun 10, 2014

Last updated

Oct 28, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Bernardoni

Title

President

Phone

(559) 494-4900

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414454400000",
    "number": "1366855025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 N. FINE AVE.",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937271513",
            "telephone_number": "559-494-4900",
            "fax_number": "559-494-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 N FINE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937271513",
            "telephone_number": "559-307-3342",
            "fax_number": "559-494-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JETHRO MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-10-28",
        "status": "A",
        "authorized_official_last_name": "BERNARDONI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-494-4900"
    },
    "taxonomies": [
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nursing Facility Supplies (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.