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NPI Code Detail

MEDICARE: JAC NAPLES L.L.C.

MEDICARE: JAC NAPLES L.L.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy

General Provider Information

NPI Number : 1083044796
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAC NAPLES L.L.C.
Provider Business Mailing Address
First Line : 1400 GULF SHORE BLVD N STE 100
Second Line :
City : NAPLES
State : FL
Zip : 34102-4971
Country : US
Telephone Number : 239-262-2222
Fax Number : 239-262-8943
Provider Business Practice Location Address
First Line : 5482 RATTLESNAKE HAMMOCK RD
Second Line :
City : NAPLES
State : FL
Zip : 34113-7454
Country : US
Telephone Number : 239-262-2222
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. ALEXANDER HERWIG
Credential : R.PH
Telephone Number : 239-262-2222
Provider Enumeration Date : 11/15/2013
Last Update Date : 11/15/2013

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