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General NPI Number Information
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NPI Number | 1346060183
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Entity Type | Organization
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Legal Business Name | JTJ MEDICAL SUPPLY, INC
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 1820 E SAHARA AVE STE 201
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City | LAS VEGAS
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State | NV
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Zip | 89104-3721
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Country | US
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Telephone | 800-939-2022
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Fax | 855-523-0910
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Provider Business Mailing Address
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Address Line | PO BOX 62134
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City | FORT MYERS
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State | FL
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Zip | 33906-2134
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Country | US
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Telephone | 800-939-2022
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Fax | 855-523-0910
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Authorized Official
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Title or Position | ADMINISTRATIVE SERVICES MANAGER
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Name | MONIQUE HARLEY-CRUZ
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Credential |
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Telephone | 800-939-2022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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