Healthcare Provider Details

I. General information

NPI: 1942131677
Provider Name (Legal Business Name): JAG HEALTHCARE SALEM INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1985 E PERSHING ST
SALEM OH
44460-3411
US

IV. Provider business mailing address

2226 WOOSTER RD
ROCKY RIVER OH
44116-2749
US

V. Phone/Fax

Practice location:
  • Phone: 330-332-1588
  • Fax:
Mailing address:
  • Phone: 440-356-0718
  • Fax: 440-356-0754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. ADEL KRUMINS
Title or Position: ACCOUNT MANAGER
Credential:
Phone: 440-667-7800