Provider Demographics
NPI:1548595150
Name:JEBCO PRIVATE SERVICES
Entity Type:Organization
Organization Name:JEBCO PRIVATE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BOWNE
Authorized Official - Suffix:
Authorized Official - Credentials:MA PCA
Authorized Official - Phone:775-209-4961
Mailing Address - Street 1:PO BOX 491
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89041-0491
Mailing Address - Country:US
Mailing Address - Phone:775-209-4961
Mailing Address - Fax:
Practice Address - Street 1:1233 S HWY 160
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89041
Practice Address - Country:US
Practice Address - Phone:775-209-4961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RJB HOLDINGS & DEVELOPMENT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health