Provider Demographics
NPI:1003349382
Name:JACOBI NATURAL HEALTH CARE
Entity Type:Organization
Organization Name:JACOBI NATURAL HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRALA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:6143-259-9744
Mailing Address - Street 1:2 ALIDENES RD
Mailing Address - Street 2:
Mailing Address - City:WILSONS CREEK
Mailing Address - State:NSW
Mailing Address - Zip Code:2482
Mailing Address - Country:AU
Mailing Address - Phone:043-259-9744
Mailing Address - Fax:
Practice Address - Street 1:2 ALIDENES RD
Practice Address - Street 2:
Practice Address - City:WILSONS CREEK
Practice Address - State:NSW
Practice Address - Zip Code:2482
Practice Address - Country:AU
Practice Address - Phone:043-259-9744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMT042261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center