Provider Demographics
NPI:1770517716
Name:JCMH HOME HEALTH PRODUCTS INC.
Entity type:Organization
Organization Name:JCMH HOME HEALTH PRODUCTS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:FRIESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-379-6840
Mailing Address - Street 1:1208 E TAMARACK RD
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-1234
Mailing Address - Country:US
Mailing Address - Phone:580-379-6800
Mailing Address - Fax:580-379-6809
Practice Address - Street 1:1208 E TAMARACK RD
Practice Address - Street 2:
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-1234
Practice Address - Country:US
Practice Address - Phone:580-379-6800
Practice Address - Fax:580-379-6809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100808930AMedicaid
OK100808930EMedicaid
OK100808930DMedicaid
OK100808930DMedicaid