Organization
J & J MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIEVES D TIMIRAOS DMEPOS (MANNAGER)
(973) 553-2405
Entity
Organization
Contact information
Practice address
669 BROADWAY, GROUND FLOOR, PATERSON, NJ 07514-1947
(973) 553-2405
Mailing address
250 5TH AVE, 1RS FLOOR, PATERSON, NJ 07524-1818
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1226387
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0213942
—
NJ
01
—
460160
WELLCARE
NJ
Enumeration date
03/13/2008
Last updated
07/11/2011
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