Provider Demographics
NPI:1326432030
Name:JEMS HEALTHCARE LLC
Entity Type:Organization
Organization Name:JEMS HEALTHCARE LLC
Other - Org Name:INFINITY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-885-7920
Mailing Address - Street 1:1521B 24TH AVE S STE 203
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6775
Mailing Address - Country:US
Mailing Address - Phone:701-885-7920
Mailing Address - Fax:701-757-0859
Practice Address - Street 1:1521B 24TH AVE S STE 203
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6775
Practice Address - Country:US
Practice Address - Phone:701-885-7920
Practice Address - Fax:701-757-0859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-20
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX539050363LG0600X
363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00223841Medicaid
ND1482911Medicaid