Provider Demographics
NPI:1386777498
Name:JI MEDICAL INC.
Entity type:Organization
Organization Name:JI MEDICAL INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:M
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-938-7411
Mailing Address - Street 1:PO BOX 64547
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-0547
Mailing Address - Country:US
Mailing Address - Phone:323-938-7411
Mailing Address - Fax:888-477-1353
Practice Address - Street 1:5812 W PICO BLVD
Practice Address - Street 2:A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-3713
Practice Address - Country:US
Practice Address - Phone:323-938-7411
Practice Address - Fax:888-477-1353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL990332B00000X
ARMG01111332BP3500X
AZW002182332BP3500X
CA20487332BP3500X
CTCSW.0002794332BP3500X
DC400312900321332BP3500X
FL1313460332BP3500X
IDDME18197332BP3500X
IL203.000828332BP3500X
IN69000405A332BP3500X
KS16-00006332BP3500X
KYHME00212332BP3500X
LADME.000236332BP3500X
MDR2666332BP3500X
CA47211332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0887990001Medicare NSC