Jenco Medical, Inc.

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

JENCO MEDICAL, INC.

Practice address

1153 N Main St
Suite B140
Logan, UT 84341-2495

Phone

(435) 750-6579

Fax

(435) 750-6586

NPI assigned

May 2, 2007

Organization subpart

No

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

Authorized official

Name

Erin Colleen Childs

Title

Office Manager

Phone

(801) 566-5795

Specialties & licenses 1

Addresses

Other names 1

• Utah Prosthetics and Orthotics Doing business as

Tax ID family

Jenco Medical Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jenco Medical, Inc.

  • Customized Equipment (DME)
  • Midvale, UT
  • NPI 1639217862
  NPD tax ID

Locations

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104047430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7026 COMMERCE PARK DR",
            "address_2": "SUITE 2",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471026",
            "telephone_number": "801-566-5795",
            "fax_number": "801-566-5790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1153 N MAIN ST",
            "address_2": "SUITE B140",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412495",
            "telephone_number": "435-750-6579",
            "fax_number": "435-750-6586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENCO MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHILDS",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "COLLEEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-566-5795"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Utah Prosthetics and Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Candice James
• Jayci K Jamison
• Lauren Jarvie
• Claire Bown Jarvis
• Jcnorman, Inc.
• Jenco Prosthetics & Orthotics, LLC
• Alysha K. Jenkins, NNP
• Bret Ira Jenkins
• Jensen Solutions, LLC
• Benjamin Benoni Jensen, D.C.

• Customized Equipment (DME) in Logan, UT
• Providers in Logan, UT by specialty
• Customized Equipment (DME) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.