Healthcare Provider Details
I. General information
NPI: 1013321132
Provider Name (Legal Business Name): ARJ MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2014
Last Update Date: 06/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
724 CORPORATE CENTER DR
POMONA CA
91768-2655
US
IV. Provider business mailing address
2980 N BEVERLY GLEN CIR SUITE 301
LOS ANGELES CA
90077-1726
US
V. Phone/Fax
- Phone: 909-941-3986
- Fax:
- Phone: 310-943-4180
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332900000X |
| Taxonomy | Non-Pharmacy Dispensing Site |
| License Number | A51383 |
| License Number State | CA |
VIII. Authorized Official
Name:
ANDREW
R.
JARMINSKI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 909-941-3986