Healthcare Provider Details

I. General information

NPI: 1043190234
Provider Name (Legal Business Name): JPK HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2025
Last Update Date: 09/06/2025
Certification Date: 09/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 LEATHER LEAF CIR
SUNBURY OH
43074-6504
US

IV. Provider business mailing address

131 LEATHER LEAF CIR
SUNBURY OH
43074-6504
US

V. Phone/Fax

Practice location:
  • Phone: 347-819-8200
  • Fax:
Mailing address:
  • Phone: 347-819-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JAMES A ADDO
Title or Position: DOO
Credential: RPH
Phone: 347-819-8200