Provider Demographics
NPI:1114522182
Name:JERNEKY BILLING & CODING LLC
Entity Type:Organization
Organization Name:JERNEKY BILLING & CODING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DE MIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGCHAMP
Authorized Official - Suffix:
Authorized Official - Credentials:CCS
Authorized Official - Phone:786-812-2578
Mailing Address - Street 1:2415 NW 162ND ST
Mailing Address - Street 2:
Mailing Address - City:OPA LOCKA
Mailing Address - State:FL
Mailing Address - Zip Code:33054-6541
Mailing Address - Country:US
Mailing Address - Phone:786-812-2578
Mailing Address - Fax:
Practice Address - Street 1:2415 NW 162ND ST
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-6541
Practice Address - Country:US
Practice Address - Phone:786-812-2578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLL525178789180Medicaid