MEDICARE: JLC MEDICAL PRODUCTS INC

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

General Provider Information

NPI Number	:	1376085613
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JLC MEDICAL PRODUCTS INC

Provider Business Mailing Address
First Line	:	405 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-4707
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	405 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-4707
Country	:	US
Telephone Number	:	917-848-9172
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JORDYN COHEN
Credential	:
Telephone Number	:	917-848-9172

Provider Enumeration Date	:	11/16/2016
Last Update Date	:	11/16/2016

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