Provider Demographics
NPI:1679760482
Name:JASSI 88 INC.
Entity Type:Organization
Organization Name:JASSI 88 INC.
Other - Org Name:JIYA MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-625-3111
Mailing Address - Street 1:724 S PRESIDENT ST
Mailing Address - Street 2:UNIT - A
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-6606
Mailing Address - Country:US
Mailing Address - Phone:630-682-5492
Mailing Address - Fax:630-682-5493
Practice Address - Street 1:724 S PRESIDENT ST
Practice Address - Street 2:UNIT - A
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-6606
Practice Address - Country:US
Practice Address - Phone:630-682-5492
Practice Address - Fax:630-682-5493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6056630001Medicare NSC