Jackson Medical Products, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0511759 Issued in TN

Legal business name

JACKSON MEDICAL PRODUCTS, LLC

Practice address

77 Business Park Dr
Lebanon, TN 37090-1237

Phone

(877) 453-3531

Fax

(855) 453-3541

NPI assigned

Nov 1, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Michael Campbell

Title

Executive Director

Phone

(615) 517-5350

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351728000000",
    "number": "1407100274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 BUSINESS PARK DR",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370901237",
            "telephone_number": "877-453-3531",
            "fax_number": "855-453-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 BUSINESS PARK DR",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370901237",
            "telephone_number": "877-453-3531",
            "fax_number": "855-453-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON MEDICAL PRODUCTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-01",
        "last_updated": "2012-11-01",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "615-517-5350",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "0511759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Michael Inglis
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• Katherine Isaacson, F.N.P.
• Amanda Jackson, PHARM.D.
• McKenzie Jackson, RD, LDN
• Mahak Jain, DDS
• James M Bachstein, MD
• Robert Joseph Jantz, M.D.

• Durable Medical Equipment & Medical Supplies in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Durable Medical Equipment & Medical Supplies in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; 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.