Provider Demographics
NPI:1023856515
Name:TRIPLE J MEDICAL SUPPLY
Entity type:Organization
Organization Name:TRIPLE J MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CHELSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MADUAGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-819-2999
Mailing Address - Street 1:9582 TARA BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-6089
Mailing Address - Country:US
Mailing Address - Phone:678-819-2999
Mailing Address - Fax:
Practice Address - Street 1:9582 TARA BLVD STE 3
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-6089
Practice Address - Country:US
Practice Address - Phone:678-819-2999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies