Provider Demographics
NPI:1104019090
Name:JKB HOLDINGS, INC
Entity Type:Organization
Organization Name:JKB HOLDINGS, INC
Other - Org Name:JAY'S MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:BURKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-835-2233
Mailing Address - Street 1:PO BOX 2298
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30514-2298
Mailing Address - Country:US
Mailing Address - Phone:706-835-2233
Mailing Address - Fax:706-835-2250
Practice Address - Street 1:77 WAYNE COLWELL DR
Practice Address - Street 2:
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512
Practice Address - Country:US
Practice Address - Phone:706-835-2233
Practice Address - Fax:706-835-2250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA268976147CMedicaid
GA268976147DMedicaid
GA52222767001OtherBLUE CROSS BLUE SHIELD
GA268976147DMedicaid