MEDICARE: JANNAH JABBARS HOUSE

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
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1093677718
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JANNAH JABBARS HOUSE

Provider Business Mailing Address
First Line	:	4219 MAGNOLIA ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-6207
Country	:	US
Telephone Number	:	504-512-2600
Fax Number	:

Provider Business Practice Location Address
First Line	:	4219 MAGNOLIA ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-6207
Country	:	US
Telephone Number	:	504-512-2600
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	JANICE FRANCES RANDOLPH
Credential	:
Telephone Number	:	504-512-2600

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “JANNAH JABBARS HOUSE ” Practice Location

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