Organization
JENNMIKE INC.
Active
Other names
Mobility Plus - Evansville
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MARIE CAGGIANO (SECRETARY/TREASURER)
(812) 550-1444
Entity
Organization
Contact information
Practice address
525 N GREEN RIVER RD, EVANSVILLE, IN 47715-2472
(812) 550-1444
(812) 550-1441
Mailing address
1975 SAINT LUCIA DR, NEWBURGH, IN 47630-9668
(216) 246-9256
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
69001599A
INDIANA PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
06/16/2020
Last updated
08/19/2020
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