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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