Provider Demographics
NPI:1922186329
Name:JUBILEE MEDICAL RESOURCES,LLC
Entity Type:Organization
Organization Name:JUBILEE MEDICAL RESOURCES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-376-0529
Mailing Address - Street 1:1953 SHADOW GLEN DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-8464
Mailing Address - Country:US
Mailing Address - Phone:919-376-0529
Mailing Address - Fax:
Practice Address - Street 1:104 S MAIN ST
Practice Address - Street 2:SUITE NUMBER A
Practice Address - City:ROLESVILLE
Practice Address - State:NC
Practice Address - Zip Code:27571-9657
Practice Address - Country:US
Practice Address - Phone:919-815-1772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies