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General NPI Number Information
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NPI Number | 1548323256
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Entity Type | Organization
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Legal Business Name | J D S MEDICAL SERVICES & SUPPLIES INC
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 02/08/2008
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Provider Practice Location Address
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Address Line | 2875 LAKEWOOD AVE SW
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City | ATLANTA
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State | GA
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Zip | 30315-5801
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Country | US
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Telephone | 404-761-1445
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Fax | 404-768-5870
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Provider Business Mailing Address
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Address Line | 541 10TH ST NW STE 297
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City | ATLANTA
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State | GA
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Zip | 30318-5713
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Country | US
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Telephone | 404-761-1445
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Fax | 404-768-5870
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Authorized Official
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Title or Position | CEO
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Name | MR. QUINTON JACKSON
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Credential |
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Telephone | 404-761-1445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | GA
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