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General NPI Number Information
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NPI Number | 1821154659
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Entity Type | Organization
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Legal Business Name | JORDON ENTERPRISES, INC.
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 2100 FAIRFAX RD SUITE 117
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City | GREENSBORO
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State | NC
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Zip | 27407-3009
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Country | US
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Telephone | 336-315-5394
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7100
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City | GREENSBORO
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State | NC
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Zip | 27417-0100
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KEN JORDON
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Credential | RRT, RCP
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Telephone | 336-315-5394
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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 | 00593
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License Number State | NC
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