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NPI Code Detail

MEDICARE: JA MEDICAL SUPPLIES.

MEDICARE: JA MEDICAL SUPPLIES.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical SuppliesC37948CA

General Provider Information

NPI Number : 1194958108
Entity Type Code : Organization
Provider Name (Legal Business Name) : JA MEDICAL SUPPLIES.
Provider Business Mailing Address
First Line : 675 N PARK AVE
Second Line :
City : POMONA
State : CA
Zip : 91768-3622
Country : US
Telephone Number : 909-868-1160
Fax Number :
Provider Business Practice Location Address
First Line : 675 N PARK AVE
Second Line :
City : POMONA
State : CA
Zip : 91768-3622
Country : US
Telephone Number : 909-868-1160
Fax Number : 909-469-6086
Authorized Official
Title or Position : ADMINISTRATIVE ASSISTANT
Name : MRS. MICHELLE ANDREA MADRIGAL
Credential :
Telephone Number : 909-868-1160
Provider Enumeration Date : 08/25/2009
Last Update Date : 08/25/2009

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Directions to “JA MEDICAL SUPPLIES. ” Practice Location

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