Organization Name: | NEW JERSEY MEDICAL SUPPLIES, LLC |
NPI Number: | 1134319692 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JACQUELINE GRACE DOMINGUEZ-YOST (PRESIDENT) |
Mailing Address: | 3111 Route 38 Larchmont Commons Bldg 8 Mount Laurel |
State: | NJ US |
Postal Code: | 080549754 |
Phone Number: | 8567783707 |
Fax Number: | |
NPI Enumeration Date: | 07/30/2007 |
NPI Last Update Date: | 02/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 1362148 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |