Provider Demographics
NPI:1558475491
Name:JD MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:JD MEDICAL SERVICES INC
Other - Org Name:GRIFFIN MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:BEN
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-275-6600
Mailing Address - Street 1:1210 BROADRICK DR STE 2
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-2676
Mailing Address - Country:US
Mailing Address - Phone:706-275-6600
Mailing Address - Fax:706-278-4347
Practice Address - Street 1:1210 BROADRICK DR STE 2
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-2676
Practice Address - Country:US
Practice Address - Phone:706-275-6600
Practice Address - Fax:706-278-4347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA332B00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000598991CMedicaid