Provider Demographics
NPI:1871816348
Name:J&M MEDICAL SUPPLY
Entity Type:Organization
Organization Name:J&M MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:AZENETH
Authorized Official - Last Name:PEDROZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-237-8851
Mailing Address - Street 1:302 E. HILLSIDE RODE
Mailing Address - Street 2:2
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041
Mailing Address - Country:US
Mailing Address - Phone:956-725-3500
Mailing Address - Fax:956-725-3501
Practice Address - Street 1:302 E. HILLSIDE RODE
Practice Address - Street 2:2
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041
Practice Address - Country:US
Practice Address - Phone:956-725-3500
Practice Address - Fax:956-725-3501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000231332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies