Provider Demographics
NPI:1841405198
Name:JKB HOLDINGS, INC.
Entity type:Organization
Organization Name:JKB HOLDINGS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:BURKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-837-1919
Mailing Address - Street 1:93 FAMILY CHURCH RD STE C
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-8893
Mailing Address - Country:US
Mailing Address - Phone:828-837-1919
Mailing Address - Fax:
Practice Address - Street 1:93 FAMILY CHURCH RD STE C
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-8893
Practice Address - Country:US
Practice Address - Phone:828-837-1919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01285332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704703Medicaid
NC045TVOtherBLUE CROSS BLUE SHIELD
GA268976147AMedicaid
GA52222767001OtherBLUE CROSS BLUE SHIELD
GA01151786OtherAMERIGROUP
NC7704703Medicaid