NPIMap

Organization Active NPI

JTJ Medical Supply, Inc

  • Community/Retail Pharmacy
  • Las Vegas, NV
National Provider Identifier
1346060183
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
JTJ MEDICAL SUPPLY, INC
Practice address
1820 E Sahara Ave Ste 201
Las Vegas, NV 89104-3721
Phone
(800) 939-2022
Fax
(855) 523-0910
NPI assigned
Oct 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Monique Harley-Cruz
Title
Administrative Services Manager
Phone
(800) 939-2022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1820 E Sahara Ave Ste 201
Las Vegas, NV 89104-3721

Mailing address

PO Box 62134
Fort Myers, FL 33906-2134
Phone (800) 939-2022

Other names 1

  • Mail-Meds Clinical Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250605003428 NV Part B Supplier - Pharmacy 0840496147 Practice locations: Las Vegas, NV

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
JTJ Medical Supply Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1729036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1346060183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62134",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339062134",
            "telephone_number": "800-939-2022",
            "fax_number": "855-523-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 E SAHARA AVE STE 201",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891043721",
            "telephone_number": "800-939-2022",
            "fax_number": "855-523-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JTJ MEDICAL SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "HARLEY-CRUZ",
        "authorized_official_first_name": "MONIQUE",
        "authorized_official_title_or_position": "ADMINISTRATIVE SERVICES MANAGER",
        "authorized_official_telephone_number": "800-939-2022"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mail-Meds Clinical Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.