Provider Demographics
NPI:1811197528
Name:JNA MEDICAL SUPPLIES LLC
Entity type:Organization
Organization Name:JNA MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:ARYEETEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-732-6152
Mailing Address - Street 1:PO BOX 240873
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224-9023
Mailing Address - Country:US
Mailing Address - Phone:414-362-0465
Mailing Address - Fax:414-755-2534
Practice Address - Street 1:8320 W BEATRICE CT
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-1700
Practice Address - Country:US
Practice Address - Phone:414-362-0465
Practice Address - Fax:414-755-2534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41741000Medicaid
5193800003Medicare NSC