Provider Demographics
NPI:1144451451
Name:J&G MEDICAL SUPPLIES AND SERVICES, INC.
Entity type:Organization
Organization Name:J&G MEDICAL SUPPLIES AND SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-302-1963
Mailing Address - Street 1:2031 QUAIL HOLLOW RUN
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-4181
Mailing Address - Country:US
Mailing Address - Phone:575-302-1963
Mailing Address - Fax:
Practice Address - Street 1:1505 W PIERCE ST
Practice Address - Street 2:SUITE D
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-4020
Practice Address - Country:US
Practice Address - Phone:575-302-1963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies