Healthcare Provider Details

I. General information

NPI: 1275804387
Provider Name (Legal Business Name): JMS BUILDERS DEVELOPERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2012
Last Update Date: 02/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 LITTLE TIMBER RDG
BUCHANAN VA
24066-4840
US

IV. Provider business mailing address

1481 LITTLE TIMBER RDG
BUCHANAN VA
24066-4840
US

V. Phone/Fax

Practice location:
  • Phone: 540-254-6627
  • Fax: 540-254-6630
Mailing address:
  • Phone: 540-254-6627
  • Fax: 540-254-6630

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: MR. JOHN M SURPRENANT
Title or Position: CEO
Credential:
Phone: 540-254-6627