Healthcare Provider Details

I. General information

NPI: 1194587345
Provider Name (Legal Business Name): JAMC OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3349 WILMINGTON RD
NEW CASTLE PA
16105-1038
US

IV. Provider business mailing address

3349 WILMINGTON RD
NEW CASTLE PA
16105-1038
US

V. Phone/Fax

Practice location:
  • Phone: 516-447-5923
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: GEDALIAH WIELGUS
Title or Position: AUTHORIZED MEMBER
Credential:
Phone: 516-447-5923