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General NPI Number Information
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NPI Number | 1598205916
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Entity Type | Organization
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Legal Business Name | JENEC GLOBAL LOGISTIC & INSURANCE LLC
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Dates
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Enumeration Date | 03/04/2017
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Last Update Date | 03/04/2017
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Provider Practice Location Address
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Address Line | 3208 JANUARY AVE APT 1
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City | SAINT LOUIS
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State | MO
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Zip | 63139-1715
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Country | US
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Telephone | 618-447-3448
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Fax |
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Provider Business Mailing Address
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Address Line | 3208 JANUARY AVE APT 1
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City | SAINT LOUIS
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State | MO
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Zip | 63139-1715
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Country | US
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Telephone | 618-447-3448
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. EDEWOR BEN OSEVWE
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Credential | RN
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Telephone | 618-447-3448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number | 2012026743
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number | 2012026743
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 2012026743
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 2012026743
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License Number State | MO
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