Provider Demographics
NPI:1932311842
Name:JR WEINSTEIN INC
Entity Type:Organization
Organization Name:JR WEINSTEIN INC
Other - Org Name:RESOURCE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEROLD
Authorized Official - Middle Name:R
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-321-9762
Mailing Address - Street 1:4009 SW 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-6817
Mailing Address - Country:US
Mailing Address - Phone:954-321-9762
Mailing Address - Fax:
Practice Address - Street 1:4009 SW 30TH AVE
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-6817
Practice Address - Country:US
Practice Address - Phone:954-321-9762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312824332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR9895OtherBLUE CROSS BLUE SHIELD
FLR9895OtherBLUE CROSS BLUE SHIELD