Provider Demographics
NPI:1841469038
Name:JOA CORPORATION DBA JOHNSON'S ORTHOPEDIC APPLIANCES INC.
Entity type:Organization
Organization Name:JOA CORPORATION DBA JOHNSON'S ORTHOPEDIC APPLIANCES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLI
Authorized Official - Middle Name:D
Authorized Official - Last Name:KEARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-785-4411
Mailing Address - Street 1:7254 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-3829
Mailing Address - Country:US
Mailing Address - Phone:951-785-4411
Mailing Address - Fax:951-785-4665
Practice Address - Street 1:81557 DOCTOR CARREON BLVD
Practice Address - Street 2:SUITE A-2
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5517
Practice Address - Country:US
Practice Address - Phone:760-863-3771
Practice Address - Fax:760-863-5601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1841469038OtherNPI
CA0210910005Medicare NSC