Healthcare Provider Details

I. General information

NPI: 1407844392
Provider Name (Legal Business Name): JAY-MED INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 E 2ND AVE
FLANDREAU SD
57028-1222
US

IV. Provider business mailing address

127 E 2ND AVE
FLANDREAU SD
57028-1222
US

V. Phone/Fax

Practice location:
  • Phone: 605-997-2122
  • Fax: 605-997-5408
Mailing address:
  • Phone: 605-997-2122
  • Fax: 605-997-5408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number1000960
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1000960
License Number StateSD

VIII. Authorized Official

Name: MS. JEANIE A. STAHL
Title or Position: OWNER
Credential: R. PH.
Phone: 605-997-2122