Provider Demographics
NPI:1629173836
Name:S & J MEDICAL
Entity Type:Organization
Organization Name:S & J MEDICAL
Other - Org Name:THE WHEELCHAIR COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOUPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-879-9050
Mailing Address - Street 1:132 MAIN ST E
Mailing Address - Street 2:
Mailing Address - City:VALDESE
Mailing Address - State:NC
Mailing Address - Zip Code:28690
Mailing Address - Country:US
Mailing Address - Phone:828-879-9050
Mailing Address - Fax:828-879-9060
Practice Address - Street 1:132 MAIN ST E
Practice Address - Street 2:
Practice Address - City:VALDESE
Practice Address - State:NC
Practice Address - Zip Code:28690
Practice Address - Country:US
Practice Address - Phone:828-879-9050
Practice Address - Fax:828-879-9060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01033332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704249Medicaid
NC046V3OtherBCBS
NC5401150001Medicare ID - Type Unspecified