Provider Demographics
NPI:1194187971
Name:JRAC HOLDINGS LLC
Entity Type:Organization
Organization Name:JRAC HOLDINGS LLC
Other - Org Name:OMNI MEDICAL SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPPELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-761-4299
Mailing Address - Street 1:990 PEACHTREE INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE 333
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-5257
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:990 PEACHTREE INDUSTRIAL BLVD
Practice Address - Street 2:SUITE 333
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-5257
Practice Address - Country:US
Practice Address - Phone:678-761-4299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies