JLC Medical, Inc

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

2009#75736 Issued in GA

Legal business name

JLC MEDICAL, INC

Practice address

2041 Kerry Creek Dr
Marietta, GA 30066-4370

Phone

(770) 973-9518

Fax

(770) 973-8463

NPI assigned

Jan 6, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Steve Mitchel Pate

Title

Ceo

Phone

(770) 973-9518

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262736000000",
    "number": "1083944482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 KERRY CREEK DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300664370",
            "telephone_number": "770-973-9518",
            "fax_number": "770-973-8463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 KERRY CREEK DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300664370",
            "telephone_number": "770-973-9518",
            "fax_number": "770-973-8463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JLC MEDICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-06",
        "last_updated": "2010-01-06",
        "status": "A",
        "authorized_official_last_name": "PATE",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "MITCHEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-973-9518",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "GA",
            "license": "2009#75736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Marietta, GA
• Providers in Marietta, GA by specialty
• Customized Equipment (DME) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.