Provider Demographics
NPI:1528384559
Name:J & C MEDICAL SUPPLY COMPANY
Entity Type:Organization
Organization Name:J & C MEDICAL SUPPLY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARRISSE
Authorized Official - Middle Name:EVOHN
Authorized Official - Last Name:DENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-385-9858
Mailing Address - Street 1:24451 LAKESHORE BLVD
Mailing Address - Street 2:SUITE 1503 WEST
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123
Mailing Address - Country:US
Mailing Address - Phone:216-385-9858
Mailing Address - Fax:216-261-3108
Practice Address - Street 1:24451 LAKESHORE BLVD
Practice Address - Street 2:SUITE 1503 WEST
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123
Practice Address - Country:US
Practice Address - Phone:216-385-9858
Practice Address - Fax:216-261-3108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies