Provider Demographics
NPI:1861890089
Name:JMACK AND COMPANY LLC
Entity type:Organization
Organization Name:JMACK AND COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-838-0053
Mailing Address - Street 1:820 S ALEXANDER RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64056-3015
Mailing Address - Country:US
Mailing Address - Phone:816-838-0053
Mailing Address - Fax:
Practice Address - Street 1:820 S ALEXANDER RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64056-3015
Practice Address - Country:US
Practice Address - Phone:816-838-0053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-22
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care