Provider Demographics
NPI:1245070689
Name:DJ HEALTH OPERATING MANAGMENT ENTERPRISES
Entity type:Organization
Organization Name:DJ HEALTH OPERATING MANAGMENT ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:PUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-380-6513
Mailing Address - Street 1:3207 OXFORD DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-5938
Mailing Address - Country:US
Mailing Address - Phone:941-380-6513
Mailing Address - Fax:
Practice Address - Street 1:3207 OXFORD DR
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-5938
Practice Address - Country:US
Practice Address - Phone:941-380-6513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization