Provider Demographics
NPI:1922603018
Name:J&J MEDICAL SUPPLY LLC.
Entity Type:Organization
Organization Name:J&J MEDICAL SUPPLY LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-302-7406
Mailing Address - Street 1:12440 FIRESTONE BLVD STE 1025
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-4369
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12440 FIRESTONE BLVD
Practice Address - Street 2:1025
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-4369
Practice Address - Country:US
Practice Address - Phone:562-406-1028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies