Provider Demographics
NPI:1316260128
Name:J&B MEDICAL SUPPLY CO INC
Entity type:Organization
Organization Name:J&B MEDICAL SUPPLY CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACT ADM
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-737-0045
Mailing Address - Street 1:50496 PONTIAC TRL
Mailing Address - Street 2:
Mailing Address - City:WIXOM
Mailing Address - State:MI
Mailing Address - Zip Code:48393-2088
Mailing Address - Country:US
Mailing Address - Phone:800-737-0045
Mailing Address - Fax:800-737-0012
Practice Address - Street 1:241 MAIN ST.
Practice Address - Street 2:
Practice Address - City:PLATTE CITY
Practice Address - State:MO
Practice Address - Zip Code:64079
Practice Address - Country:US
Practice Address - Phone:816-858-7016
Practice Address - Fax:816-858-7017
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:J&B MEDICAL SUPPLY CO INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-08
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL 916824332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies