Healthcare Provider Details

I. General information

NPI: 1285283044
Provider Name (Legal Business Name): JK MARKETING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2019
Last Update Date: 09/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6091 STEUBENVILLE PIKE STE 7B
MC KEES ROCKS PA
15136-1336
US

IV. Provider business mailing address

280 INDIAN SPRINGS RD STE 131
INDIANA PA
15701-3676
US

V. Phone/Fax

Practice location:
  • Phone: 877-413-0299
  • Fax: 844-595-3314
Mailing address:
  • Phone: 724-717-2211
  • Fax: 724-463-9301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JAMES A KODMAN
Title or Position: CEO
Credential:
Phone: 724-717-2211