Organization
JACKSON MEDICAL EQUIPMENT, INC.
Active
Organization
JACKSON MEDICAL EQUIPMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOEL PITTMAN (VICE PRESIDENT)
(651) 645-6221
Entity
Organization
Contact information
Practice address
982 THOMAS AVE, SAINT PAUL, MN 55104-2638
(651) 645-6221
Mailing address
982 THOMAS AVE, SAINT PAUL, MN 55104-2638
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107274
UCAREMN
MN
01
—
32719
HEALTHPARTNERS
MN
05
—
345563700
—
MN
01
—
61989ME
BLUE CROSS BLUE SHIELD
MN
01
—
7007575
PREFERREDONE
MN
01
—
8283840
MEDICA
MN
Enumeration date
04/15/2006
Last updated
05/28/2010
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