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NPI Code Detail

MEDICARE: JJACKS LLC

MEDICARE: JJACKS 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
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1437953734
Entity Type Code : Organization
Provider Name (Legal Business Name) : JJACKS LLC
Provider Business Mailing Address
First Line : 500 FENCEPOST LN
Second Line :
City : ROCK HILL
State : SC
Zip : 29730-8142
Country : US
Telephone Number : 803-853-3088
Fax Number :
Provider Business Practice Location Address
First Line : 2241 EBENEZER RD STE 12
Second Line :
City : ROCK HILL
State : SC
Zip : 29732-9288
Country : US
Telephone Number : 803-853-3088
Fax Number :
Authorized Official
Title or Position : OWNER/ADMINISTRATOR
Name : MRS. CRYSTAL K STEWART
Credential :
Telephone Number : 803-524-3877
Provider Enumeration Date : 04/03/2025
Last Update Date : 04/03/2025

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Directions to “JJACKS LLC ” Practice Location

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