Provider Demographics
NPI:1104950617
Name:JSJ ENTERPRISES, L.L.C.
Entity type:Organization
Organization Name:JSJ ENTERPRISES, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JANSSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-252-1527
Mailing Address - Street 1:1801 N INDIANWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-1149
Mailing Address - Country:US
Mailing Address - Phone:918-252-1527
Mailing Address - Fax:918-252-2446
Practice Address - Street 1:1000 CORNELL PKWY
Practice Address - Street 2:SUITE #300
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73108-1886
Practice Address - Country:US
Practice Address - Phone:405-945-0144
Practice Address - Fax:405-945-0146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1-S-1047332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK4638590002Medicare NSC