Provider Demographics
NPI:1912230699
Name:JP INNOVATIONS, INC.
Entity Type:Organization
Organization Name:JP INNOVATIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-445-0922
Mailing Address - Street 1:4007 MCCULLOUGH AVE
Mailing Address - Street 2:SUITE 497
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-2420
Mailing Address - Country:US
Mailing Address - Phone:210-445-0955
Mailing Address - Fax:210-738-2355
Practice Address - Street 1:1222 BABCOCK RD
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-6601
Practice Address - Country:US
Practice Address - Phone:210-445-0922
Practice Address - Fax:210-738-2355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site