Organization
JACOBS MEDICAL SUPPLY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY VALERA NERIA (PRESIDENT)
(916) 647-4193
Entity
Organization
Contact information
Practice address
8213 CRICHTON WAY, ELK GROVE, CA 95758-8028
(916) 647-4193
(916) 896-5115
Mailing address
8213 CRICHTON WAY, ELK GROVE, CA 95758-8028
(916) 647-4193
(916) 896-5115
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
201013710108
CA
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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