Provider Demographics
NPI:1811172497
Name:J&B MEDICAL SUPPLY CO INC
Entity type:Organization
Organization Name:J&B MEDICAL SUPPLY CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACT ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-737-0045
Mailing Address - Street 1:10824 COUNTY ROAD 44
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-2614
Mailing Address - Country:US
Mailing Address - Phone:352-275-9270
Mailing Address - Fax:800-737-0012
Practice Address - Street 1:10824 COUNTY ROAD 44
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-2614
Practice Address - Country:US
Practice Address - Phone:352-357-2415
Practice Address - Fax:352-357-2417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4981690002Medicare NSC