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General NPI Number Information
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NPI Number | 1871816348
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Entity Type | Organization
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Legal Business Name | J&M MEDICAL SUPPLY
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Dates
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Enumeration Date | 03/11/2010
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Last Update Date | 03/11/2010
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Provider Practice Location Address
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Address Line | 302 E. HILLSIDE RODE 2
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City | LAREDO
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State | TX
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Zip | 78041
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Country | US
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Telephone | 956-725-3500
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Fax | 956-725-3501
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Provider Business Mailing Address
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Address Line | 302 E. HILLSIDE RODE 2
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City | LAREDO
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State | TX
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Zip | 78041
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Country | US
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Telephone | 956-725-3500
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Fax | 956-725-3501
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MRS. JESSICA AZENETH PEDROZA
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Credential |
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Telephone | 956-237-8851
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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 | 1000231
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License Number State | TX
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