Healthcare Provider Details

I. General information

NPI: 1114594082
Provider Name (Legal Business Name): JMHHH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2021
Last Update Date: 06/08/2021
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 N MACARTHUR BLVD STE 225
IRVING TX
75039-2482
US

IV. Provider business mailing address

6565 N MACARTHUR BLVD STE 225
IRVING TX
75039-2482
US

V. Phone/Fax

Practice location:
  • Phone: 469-395-8402
  • Fax:
Mailing address:
  • Phone: 469-395-8402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MARTIN T FULLER
Title or Position: OWNER
Credential:
Phone: 469-395-8402