Organization
MAR-J MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON HOUSENBOLD (PRESIDENT)
(561) 347-7997
Entity
Organization
Contact information
Practice address
801 MEADOWS RD, STE 101, BOCA RATON, FL 33486-2346
(561) 347-7997
(561) 417-5588
Mailing address
801 MEADOWS RD, SUITE 101, BOCA RATON, FL 33486-2346
(561) 347-7997
(561) 417-5588
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1338
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022811700
—
FL
01
—
241622
AMERIGROUP
FL
01
—
R9245
BCBS
FL
Enumeration date
05/27/2005
Last updated
01/27/2020
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