Provider Demographics
NPI:1215159900
Name:J & N REMODELING
Entity type:Organization
Organization Name:J & N REMODELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:NIELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-947-4640
Mailing Address - Street 1:1516 GALAXIE DR
Mailing Address - Street 2:
Mailing Address - City:HINTON
Mailing Address - State:IA
Mailing Address - Zip Code:51024-8806
Mailing Address - Country:US
Mailing Address - Phone:712-947-4640
Mailing Address - Fax:
Practice Address - Street 1:1516 GALAXIE DR
Practice Address - Street 2:
Practice Address - City:HINTON
Practice Address - State:IA
Practice Address - Zip Code:51024-8806
Practice Address - Country:US
Practice Address - Phone:712-947-4640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0737890Medicaid