Provider Demographics
NPI:1225122427
Name:JR SUPPLY CORP
Entity Type:Organization
Organization Name:JR SUPPLY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:ALBELO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:305-817-8838
Mailing Address - Street 1:3961 W 9TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7229
Mailing Address - Country:US
Mailing Address - Phone:305-794-8023
Mailing Address - Fax:305-817-8838
Practice Address - Street 1:3750 W 16TH AVE
Practice Address - Street 2:240AU
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4654
Practice Address - Country:US
Practice Address - Phone:305-817-8838
Practice Address - Fax:305-817-8838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies