Provider Demographics
NPI:1598364176
Name:JACE MEDICAL LLC
Entity Type:Organization
Organization Name:JACE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:STEFFENSMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-527-9427
Mailing Address - Street 1:3516 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46580-3925
Mailing Address - Country:US
Mailing Address - Phone:574-306-0355
Mailing Address - Fax:574-306-0363
Practice Address - Street 1:3516 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-3925
Practice Address - Country:US
Practice Address - Phone:574-306-0355
Practice Address - Fax:574-306-0363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies