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NPI Code Detail

MEDICARE: JQ MEDICAL SUPPLY, LLC

MEDICARE: JQ MEDICAL SUPPLY, LLC
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 SuppliesE42635UT

Other Identifiers

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

General Provider Information

NPI Number : 1619960663
Entity Type Code : Organization
Provider Name (Legal Business Name) : JQ MEDICAL SUPPLY, LLC
Provider Business Mailing Address
First Line : 1225 E FORT UNION BLVD STE 310
Second Line :
City : MIDVALE
State : UT
Zip : 84047-1883
Country : US
Telephone Number : 801-942-8582
Fax Number : 801-880-3634
Provider Business Practice Location Address
First Line : 6910 S HIGHLAND DR STE 4
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84121-3087
Country : US
Telephone Number : 800-231-6820
Fax Number : 801-880-3634
Authorized Official
Title or Position : VICE PRESIDENT OF REVENUE CYCLE
Name : TRICIA THURMAN
Credential :
Telephone Number : 801-942-8582
Provider Enumeration Date : 08/24/2005
Last Update Date : 07/24/2025

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Directions to “JQ MEDICAL SUPPLY, LLC ” Practice Location

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