NPIMap

Organization Active NPI

Jubilee Healthcare LLC

  • Durable Medical Equipment & Medical Supplies
  • Westlake, OH
National Provider Identifier
1306397120
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
JUBILEE HEALTHCARE LLC
Practice address
25200 Center Ridge Rd Ste 1100
Westlake, OH 44145
Phone
(844) 746-8537
Fax
(216) 450-1810
NPI assigned
Oct 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Mr. Fred Degrandis
Title
President
Phone
(216) 312-5059

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

25200 Center Ridge Rd Ste 1100
Westlake, OH 44145

Mailing address

25200 Center Ridge Rd Ste 1100
Westlake, OH 44145-4146
Phone (844) 746-8537

Other identifiers 1

IdentifierTypeStateIssuer
0192836MedicaidOH

Other names 1

  • North Shore Healthcare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jubilee Healthcare LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1306397120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25200 CENTER RIDGE RD STE 1100",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441454146",
            "telephone_number": "844-746-8537",
            "fax_number": "216-450-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25200 CENTER RIDGE RD STE 1100",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "44145",
            "telephone_number": "844-746-8537",
            "fax_number": "216-450-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUBILEE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "DEGRANDIS",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-312-5059",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0192836",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Shore Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Shore Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.