Provider Demographics
NPI:1619262912
Name:JV MEDICAL EQUIPMENT & SUPPLIES LLC
Entity Type:Organization
Organization Name:JV MEDICAL EQUIPMENT & SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARDIA
Authorized Official - Middle Name:O
Authorized Official - Last Name:VICTOR
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:832-896-6041
Mailing Address - Street 1:2400 CENTRAL PKWY
Mailing Address - Street 2:SUITE L
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-7732
Mailing Address - Country:US
Mailing Address - Phone:713-688-3147
Mailing Address - Fax:
Practice Address - Street 1:2400 CENTRAL PKWY
Practice Address - Street 2:SUITE L
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-7732
Practice Address - Country:US
Practice Address - Phone:713-688-3147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0801396930332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies