CHARLES F. JURACKA NPI 1023294915

Durable Medical Equipment & Medical Supplies (Customized Equipment) in Schenectady, NY

NPI 1023294915 Organization Durable Medical Equipment & Medical Supp... Customized Equipment

About CHARLES F. JURACKA

Charles F. Juracka is a provider established in Schenectady, New York specializing in durable medical equipment & medical supplies (customized equipment) . The NPI number of Charles F. Juracka is 1023294915 and was assigned on January 2008. The practitioner's primary taxonomy code is 332BC3200X with license number C002465-1 (NY). The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Mr. Charles F Juracka Optician (Owner/optician)

NPI

1023294915

Provider NameCHARLES F. JURACKA
Provider Location Address604 UNION ST SCHENECTADY, NY 12305
Provider Mailing Address604 UNION ST SCHENECTADY, NY 12305
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date01-10-2008
Last Update Date04-22-2008


Primary Taxonomy

Taxonomy Code332BC3200X
ClassificationDurable Medical Equipment & Medical Supplies
TypeSuppliers
SpecializationCustomized Equipment
License No.C002465-1
License StateNY

Business Address

CHARLES F. JURACKA
604 UNION ST
SCHENECTADY, NY
ZIP 12305
Phone: (518) 377-1283
Fax: (518) 370-5058

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Mailing Address

CHARLES F. JURACKA
604 UNION ST
SCHENECTADY, NY
ZIP 12305
Phone: (518) 377-1283
Fax: (518) 370-5058



Authorized Official

Authorized Official NameMR. CHARLES F JURACKA OPTICIAN
Authorized Official TitleOWNER/OPTICIAN
Authorized Official Phone(518) 377-1283

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
0368580001MEDICARE NSC (07)NY

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1235770751 JOSEPH GOODNOUGH LICENSED OPTICIAN
Individual
Technician/Technologist (Optician)604 UNION ST
SCHENECTADY, NY 12305
(518) 231-9750

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.