Provider Demographics
NPI:1083790349
Name:JHAMB ENTERPRISES, INC.
Entity Type:Organization
Organization Name:JHAMB ENTERPRISES, INC.
Other - Org Name:GATEWAY HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:BOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-820-0505
Mailing Address - Street 1:PO BOX 6199
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76115-0199
Mailing Address - Country:US
Mailing Address - Phone:817-820-0505
Mailing Address - Fax:817-820-0576
Practice Address - Street 1:99 REGENCY PARKWAY
Practice Address - Street 2:SUITE 107
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063
Practice Address - Country:US
Practice Address - Phone:817-453-0605
Practice Address - Fax:817-453-0619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-30
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0092091332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5336830002Medicare NSC