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Organization

J. PEN MEDICAL, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACOB MARK NYGAARD (SEC/TRES)
(828) 652-1989
Entity
Organization

Contact information

Practice address
135 S MAIN ST, MARION, NC 28752-4548
(828) 652-1989
(828) 652-8990
Mailing address
PO BOX 975, MARION, NC 28752-0975
(828) 652-1989
(828) 652-8990

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
00484
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7703089
NC
01
C08500402
CMS - MEDICARE EDI OPERATIONS - PALMETTO GBA
Enumeration date
08/09/2005
Last updated
04/28/2008
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