Provider Demographics
NPI:1699097618
Name:JLM GROUP INC
Entity type:Organization
Organization Name:JLM GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-664-6492
Mailing Address - Street 1:7000 STORAGE CT
Mailing Address - Street 2:SUITE 4
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-0700
Mailing Address - Country:US
Mailing Address - Phone:678-664-6492
Mailing Address - Fax:770-234-4025
Practice Address - Street 1:7000 STORAGE CT
Practice Address - Street 2:SUITE 4
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-0700
Practice Address - Country:US
Practice Address - Phone:678-664-6492
Practice Address - Fax:770-234-4025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center