Provider Demographics
NPI:1316126030
Name:JP MEDICAL SOLUTIONS, LLC
Entity type:Organization
Organization Name:JP MEDICAL SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SALES & MARKETING
Authorized Official - Prefix:MR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:PENAHERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MA
Authorized Official - Phone:707-202-4542
Mailing Address - Street 1:2360 MENDOCINO AVE
Mailing Address - Street 2:A2-205
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-3153
Mailing Address - Country:US
Mailing Address - Phone:707-202-4542
Mailing Address - Fax:707-237-2531
Practice Address - Street 1:2360 MENDOCINO AVE
Practice Address - Street 2:A2-205
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-3153
Practice Address - Country:US
Practice Address - Phone:707-202-4542
Practice Address - Fax:707-237-2531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies