Provider Demographics
NPI:1427382118
Name:JANMED SUPPLY COMPANY, INC
Entity Type:Organization
Organization Name:JANMED SUPPLY COMPANY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENU
Authorized Official - Middle Name:
Authorized Official - Last Name:GOEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-519-0550
Mailing Address - Street 1:1059 RIDGEWOOD PL
Mailing Address - Street 2:SUITE A
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-2018
Mailing Address - Country:US
Mailing Address - Phone:601-519-0550
Mailing Address - Fax:601-519-0553
Practice Address - Street 1:1059 RIDGEWOOD PL
Practice Address - Street 2:SUITE A
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-2018
Practice Address - Country:US
Practice Address - Phone:601-519-0550
Practice Address - Fax:601-519-0553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-28
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS6426730001Medicare NSC