| Organization Name: | B & J CUSTOM DME, LLC. |
| NPI Number: | 1770598526 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUSTIN EDWARD MORGAN (MANAGER) |
| Mailing Address: | 1335 N. Pacific Hwy Suite 150 Woodburn |
| State: | OR US |
| Postal Code: | 970713617 |
| Phone Number: | 5039828598 |
| Fax Number: | 5039828598 |
| NPI Enumeration Date: | 07/30/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 313656-95 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| 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 |