MEDICARE: J&B MEDICAL SUPPLY CO INC

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
1	332B00000X	Durable Medical Equipment & Medical Supplies	B ME-0145457	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417941774
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J&B MEDICAL SUPPLY CO INC

Provider Business Mailing Address
First Line	:	50496 W. PONTIAC TRL
Second Line	:
City	:	WIXOM
State	:	MI
Zip	:	48393-2027
Country	:	US
Telephone Number	:	800-737-0045
Fax Number	:	800-737-0012

Provider Business Practice Location Address
First Line	:	50496 W. PONTIAC TRL
Second Line	:
City	:	WIXOM
State	:	MI
Zip	:	48393-2027
Country	:	US
Telephone Number	:	800-737-0045
Fax Number	:	800-737-0012

Authorized Official
Title or Position	:	V.P.
Name	:	MR. JULIAN SHAYA
Credential	:
Telephone Number	:	248-360-9977

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	11/10/2011

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Directions to “J&B MEDICAL SUPPLY CO INC ” Practice Location

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