Provider Demographics
NPI:1528126141
Name:J. C. HOME CARE INC
Entity type:Organization
Organization Name:J. C. HOME CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAE
Authorized Official - Middle Name:HOON
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-448-9827
Mailing Address - Street 1:9309 OLD KINGS RD S STE 4
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-6180
Mailing Address - Country:US
Mailing Address - Phone:904-448-9827
Mailing Address - Fax:904-425-4948
Practice Address - Street 1:9309 OLD KINGS RD S STE 4
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-6180
Practice Address - Country:US
Practice Address - Phone:904-448-9827
Practice Address - Fax:904-425-4948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2275332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001341300Medicaid
FLR9604OtherBCBS
FL1025438OtherUNITED
FL1025438OtherUNITED
FL4917440001Medicare NSC