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Individual

JAMEE RUDDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3 HENDRICK LN, CARBONDALE, PA 18407-2015
(570) 687-5242
Mailing address
3 HENDRICK LN, CARBONDALE, PA 18407-2015
(570) 687-5242

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH001866
PA
252Y00000X
Early Intervention Provider Agency
1031020430001
PA
253Z00000X
In Home Supportive Care Agency
332B00000X
Durable Medical Equipment & Medical Supplies
332BC3200X
Customized Equipment (DME)
332BD1200X
Dialysis Equipment & Supplies (DME)
332BN1400X
Nursing Facility Supplies (DME)
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
332BX2000X
Oxygen Equipment & Supplies (DME)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1031020430001
MEDICAL ASSISTANCE
PA
05
1031020430001
PA
Enumeration date
07/07/2017
Last updated
02/14/2026
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