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General NPI Number Information
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NPI Number | 1194024539
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Entity Type | Organization
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Legal Business Name | JMC HAIRWEAR AND DURABLE MEDICAL SUPPLIES
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Dates
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Enumeration Date | 03/24/2011
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Last Update Date | 03/24/2011
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Provider Practice Location Address
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Address Line | 2900 W SAMPLE RD #2301
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City | POMPANO BEACH
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State | FL
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Zip | 33073-3024
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Country | US
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Telephone | 957-975-5760
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Fax | 957-766-4416
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Provider Business Mailing Address
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Address Line | 2900 W SAMPLE RD #2301
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City | POMPANO BEACH
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State | FL
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Zip | 33073-3024
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Country | US
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Telephone | 954-975-5760
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Fax | 954-766-4416
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARYN LISA DERI
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Credential |
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Telephone | 954-975-5760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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