Provider Demographics
NPI:1639282965
Name:JABEZ HOME INFUSION COMPANY
Entity Type:Organization
Organization Name:JABEZ HOME INFUSION COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:COWART
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:252-758-9304
Mailing Address - Street 1:2495 HEMBY LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-3771
Mailing Address - Country:US
Mailing Address - Phone:252-758-9304
Mailing Address - Fax:252-758-6904
Practice Address - Street 1:2495 HEMBY LN
Practice Address - Street 2:SUITE B
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3771
Practice Address - Country:US
Practice Address - Phone:252-758-9304
Practice Address - Fax:252-758-6904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC22913336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC046JVOtherBCBS DME PROVIDER #