Provider Demographics
NPI:1548851066
Name:JTC VENTURES LLC DBAUPSTATE MOBILITY
Entity type:Organization
Organization Name:JTC VENTURES LLC DBAUPSTATE MOBILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CULP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-757-1601
Mailing Address - Street 1:PO BOX 81208
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-0021
Mailing Address - Country:US
Mailing Address - Phone:864-757-1601
Mailing Address - Fax:864-757-8141
Practice Address - Street 1:508 SE MAIN ST
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-3216
Practice Address - Country:US
Practice Address - Phone:864-757-1601
Practice Address - Fax:864-757-8141
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JTC VENTURES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-27
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies