Organization
JACKSON MEDICAL SUPPLY INC
Active
Parent organization
JACKSON MEDICAL SUPPLY INC
Other names
JACKSON MEDICAL SUPPLY
Organization subpart
Yes
Provider details
NPI number
Legal business name
JACKSON MEDICAL SUPPLY INC
Authorized official
MS. WENDY ANN WIGMORE (OWNER, CFO)
(707) 446-7014
Entity
Organization
Contact information
Practice address
480 REDWOOD ST, # 44, VALLEJO, CA 94590-2958
(707) 644-4170
(707) 644-4163
Mailing address
480 REDWOOD ST, # 44, VALLEJO, CA 94590-2958
(707) 644-4170
(707) 644-4163
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
53238
CA
Other
Enumeration date
10/08/2010
Last updated
10/08/2010
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