Provider Demographics
NPI:1073841953
Name:J MEDICAL
Entity type:Organization
Organization Name:J MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-594-0094
Mailing Address - Street 1:9616 HAMILTON HILLS DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2070
Mailing Address - Country:US
Mailing Address - Phone:317-594-0094
Mailing Address - Fax:
Practice Address - Street 1:9616 HAMILTON HILLS DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2070
Practice Address - Country:US
Practice Address - Phone:317-594-0094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies