Healthcare Provider Details

I. General information

NPI: 1316260128
Provider Name (Legal Business Name): J&B MEDICAL SUPPLY CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2010
Last Update Date: 03/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 MAIN ST.
PLATTE CITY MO
64079
US

IV. Provider business mailing address

50496 PONTIAC TRL
WIXOM MI
48393-2088
US

V. Phone/Fax

Practice location:
  • Phone: 816-858-7016
  • Fax: 816-858-7017
Mailing address:
  • Phone: 800-737-0045
  • Fax: 800-737-0012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberL 916824
License Number StateMI

VIII. Authorized Official

Name: RAY J ZAK
Title or Position: CONTRACT ADM
Credential:
Phone: 800-737-0045