MEDICARE: JPLUS INTERNATIONAL 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	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1790377604
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JPLUS INTERNATIONAL INC

Provider Business Mailing Address
First Line	:	3920 W CHARLESTON BLVD STE N
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1651
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3920 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1631
Country	:	US
Telephone Number	:	702-478-5541
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	BREONNA YOUNG
Credential	:
Telephone Number	:	702-478-5541

Provider Enumeration Date	:	02/11/2021
Last Update Date	:	02/11/2021

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Directions to “JPLUS INTERNATIONAL INC ” Practice Location

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