Provider Demographics
NPI:1194847582
Name:JTB MEDICAL EQUIPMENT & SERVICES, INC.
Entity Type:Organization
Organization Name:JTB MEDICAL EQUIPMENT & SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN DIRECOTOR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCCAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-808-9811
Mailing Address - Street 1:9950 WESTPARK DR
Mailing Address - Street 2:338
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5138
Mailing Address - Country:US
Mailing Address - Phone:713-808-9811
Mailing Address - Fax:713-808-9756
Practice Address - Street 1:9950 WESTPARK DR
Practice Address - Street 2:338
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5138
Practice Address - Country:US
Practice Address - Phone:713-808-9811
Practice Address - Fax:713-808-9756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0094090332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5886290001Medicare UPIN