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NPI Code Detail

MEDICARE: JUPITER MEDICAL CORP, SC

MEDICARE: JUPITER MEDICAL CORP, SC
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

General Provider Information

NPI Number : 1770841355
Entity Type Code : Organization
Provider Name (Legal Business Name) : JUPITER MEDICAL CORP, SC
Provider Business Mailing Address
First Line : 1645 W SCHOOL ST # A
Second Line : STOC1
City : CHICAGO
State : IL
Zip : 60657-2157
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1645 W SCHOOL ST # A
Second Line : STOC1
City : CHICAGO
State : IL
Zip : 60657-2157
Country : US
Telephone Number : 773-227-3669
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : ABHIJIT SHINDE
Credential : MD
Telephone Number : 773-227-3669
Provider Enumeration Date : 05/02/2012
Last Update Date : 05/02/2012

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Directions to “JUPITER MEDICAL CORP, SC ” Practice Location

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