Provider Demographics
NPI:1043492564
Name:JCBC INCORPORATED
Entity Type:Organization
Organization Name:JCBC INCORPORATED
Other - Org Name:AC MEDICAL SUPPLIES & EQUIPMENT
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CELINE
Authorized Official - Middle Name:T
Authorized Official - Last Name:DONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-493-4718
Mailing Address - Street 1:12440 OXFORD PARK DR STE C-106
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2792
Mailing Address - Country:US
Mailing Address - Phone:281-493-4718
Mailing Address - Fax:281-493-4716
Practice Address - Street 1:12440 OXFORD PARK DR STE C-106
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2792
Practice Address - Country:US
Practice Address - Phone:281-493-4718
Practice Address - Fax:281-493-4716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195956103Medicaid
TX195956101Medicaid
TX195956105Medicaid
TX195956103Medicaid