Provider Demographics
NPI:1275804387
Name:JMS BUILDERS DEVELOPERS
Entity Type:Organization
Organization Name:JMS BUILDERS DEVELOPERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SURPRENANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-254-6627
Mailing Address - Street 1:1481 LITTLE TIMBER RDG
Mailing Address - Street 2:
Mailing Address - City:BUCHANAN
Mailing Address - State:VA
Mailing Address - Zip Code:24066-4840
Mailing Address - Country:US
Mailing Address - Phone:540-254-6627
Mailing Address - Fax:540-254-6630
Practice Address - Street 1:1481 LITTLE TIMBER RDG
Practice Address - Street 2:
Practice Address - City:BUCHANAN
Practice Address - State:VA
Practice Address - Zip Code:24066-4840
Practice Address - Country:US
Practice Address - Phone:540-254-6627
Practice Address - Fax:540-254-6630
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMITY FELLOWSERVE INC. DBA KISSITO HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-20
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2705077143AOtherCONTRACTOR'S LICENSE