Provider Demographics
NPI:1447402508
Name:JRS ENTERPRISE, LLC
Entity Type:Organization
Organization Name:JRS ENTERPRISE, LLC
Other - Org Name:MEDICARESUPPLYGROUP.COM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-758-3306
Mailing Address - Street 1:7730B TRINITY ROAD
Mailing Address - Street 2:SUITE 124
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-2725
Mailing Address - Country:US
Mailing Address - Phone:901-758-3306
Mailing Address - Fax:901-755-6963
Practice Address - Street 1:7730B TRINITY ROAD
Practice Address - Street 2:SUITE 124
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-2725
Practice Address - Country:US
Practice Address - Phone:901-758-3306
Practice Address - Fax:901-755-6963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies