Provider Demographics
NPI:1285214700
Name:JAM HEALTHCARE SERVICES SUPPLIES, INC
Entity Type:Organization
Organization Name:JAM HEALTHCARE SERVICES SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-801-2863
Mailing Address - Street 1:750 S ORANGE BLOSSOM TRL STE 41
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-3138
Mailing Address - Country:US
Mailing Address - Phone:407-801-2863
Mailing Address - Fax:407-350-3185
Practice Address - Street 1:750 S ORANGE BLOSSOM TRL STE 41
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-3138
Practice Address - Country:US
Practice Address - Phone:407-801-2863
Practice Address - Fax:407-350-3185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-09
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies