MEDICARE: JMR MEDICAL, LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies	HMEL.11025	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	HMEL.11025	OTHER	OH	STATE LICENSE

General Provider Information

NPI Number	:	1114975620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JMR MEDICAL, LLC

Provider Business Mailing Address
First Line	:	555 E NORTH LN STE 5075
Second Line	:
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2490
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9821 OLDE 8 RD STE D1
Second Line	:
City	:	NORTHFIELD
State	:	OH
Zip	:	44067-1456
Country	:	US
Telephone Number	:	234-201-1076
Fax Number	:	330-467-1839

Authorized Official
Title or Position	:	CCO
Name	:	WENDY RUSSALESI
Credential	:
Telephone Number	:	484-246-9499

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	01/28/2026

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Directions to “JMR MEDICAL, LLC ” Practice Location

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