Provider Demographics
NPI:1194445239
Name:JRK MEDICAL LLC
Entity type:Organization
Organization Name:JRK MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER (MEDICAL DIRECTOR)
Authorized Official - Prefix:
Authorized Official - First Name:HENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KALSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-332-6900
Mailing Address - Street 1:PO BOX 5865
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55903-5865
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 VILLAGE CENTER DR STE 800
Practice Address - Street 2:
Practice Address - City:NORTH OAKS
Practice Address - State:MN
Practice Address - Zip Code:55127-7201
Practice Address - Country:US
Practice Address - Phone:507-322-6900
Practice Address - Fax:507-322-6967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies