Healthcare Provider Details

I. General information

NPI: 1639156185
Provider Name (Legal Business Name): JCR MANAGEMENT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 COBB ST SUITE A
JONESBORO AR
72401-4110
US

IV. Provider business mailing address

824 COBB ST
JONESBORO AR
72401-4110
US

V. Phone/Fax

Practice location:
  • Phone: 870-972-8062
  • Fax: 870-345-7262
Mailing address:
  • Phone: 870-972-8062
  • Fax: 870-345-7262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: BRANDI MELTON
Title or Position: PRESIDENT
Credential:
Phone: 870-972-8062