Provider Demographics
NPI:1912170143
Name:JSC MEDICAL EQUIPMENT
Entity type:Organization
Organization Name:JSC MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SILVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-486-2250
Mailing Address - Street 1:2400 WOODVILLE RD
Mailing Address - Street 2:
Mailing Address - City:UNION POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30669-1946
Mailing Address - Country:US
Mailing Address - Phone:706-486-2250
Mailing Address - Fax:
Practice Address - Street 1:2400 WOODVILLE RD
Practice Address - Street 2:
Practice Address - City:UNION POINT
Practice Address - State:GA
Practice Address - Zip Code:30669-1946
Practice Address - Country:US
Practice Address - Phone:706-486-2250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA332BX2000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1288520001Medicare NSC