Provider Demographics
NPI: | 1427667781 |
---|---|
Name: | JANZ MEDICAL SUPPLY |
Entity type: | Organization |
Organization Name: | JANZ MEDICAL SUPPLY |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | VP |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CHUCK |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | OLDER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 615-878-2476 |
Mailing Address - Street 1: | 275 OUTERBELT ST |
Mailing Address - Street 2: | |
Mailing Address - City: | COLUMBUS |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 43213-1529 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 614-759-7700 |
Mailing Address - Fax: | |
Practice Address - Street 1: | BUILDING 998 BOSTON RD |
Practice Address - Street 2: | IP27 9PN |
Practice Address - City: | BRANDON |
Practice Address - State: | ENGLAND |
Practice Address - Zip Code: | IP27 9PN |
Practice Address - Country: | GB |
Practice Address - Phone: | 615-878-2476 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | JANZ CORPORATION |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2020-07-23 |
Last Update Date: | 2022-04-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
3834467330 | Other | TRICARE SOS |