Provider Demographics
NPI:1306244074
Name:J MEDICAL INC
Entity type:Organization
Organization Name:J MEDICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-328-3332
Mailing Address - Street 1:12510 E ILIFF AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-6377
Mailing Address - Country:US
Mailing Address - Phone:303-862-8853
Mailing Address - Fax:720-379-5827
Practice Address - Street 1:9101 PEARL ST STE 350
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4390
Practice Address - Country:US
Practice Address - Phone:720-328-1246
Practice Address - Fax:720-389-6543
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:J MEDICAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-12-12
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO15956369Medicaid
CO15956369Medicaid