Organization
JENCO MEDICAL AND MOBILITY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM GHOLSON (PRESIDENT)
(812) 352-8440
Entity
Organization
Contact information
Practice address
2202 N TOTTEN CIR, STE A, NORTH VERNON, IN 47265-6380
(812) 352-8440
(812) 352-8220
Mailing address
2202 N TOTTEN CIR, STE A, NORTH VERNON, IN 47265-6380
(812) 352-8440
(812) 352-8220
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000189761
ANTHEM
IN
Enumeration date
08/28/2006
Last updated
03/21/2008
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