Provider Demographics
NPI:1386112308
Name:JENBRU GROUP INC
Entity type:Organization
Organization Name:JENBRU GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BRU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-320-9777
Mailing Address - Street 1:1025 E HALLANDALE BEACH BLVD STE 15
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4478
Mailing Address - Country:US
Mailing Address - Phone:954-320-9777
Mailing Address - Fax:954-320-9778
Practice Address - Street 1:1025 E HALLANDALE BEACH BLVD STE 15-727
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4478
Practice Address - Country:US
Practice Address - Phone:954-320-9777
Practice Address - Fax:954-320-9778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies