Healthcare Provider Details

I. General information

NPI: 1982882916
Provider Name (Legal Business Name): JMS MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2008
Last Update Date: 01/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 MIRALOMA WAY SUITE X
SUNNYVALE CA
94085-4600
US

IV. Provider business mailing address

1190 MIRALOMA WAY SUITE X
SUNNYVALE CA
94085-4600
US

V. Phone/Fax

Practice location:
  • Phone: 408-481-3829
  • Fax: 408-481-0847
Mailing address:
  • Phone: 408-481-3829
  • Fax: 408-481-0847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. MONTCHAI SURIYAMONT
Title or Position: PRESIDENT
Credential: MBA
Phone: 408-481-3829