J&B MEDICAL SUPPLY CO INC
Complete NPI Record 1326881921
Durable Medical Equipment & Medical Supplies in Gallup, NM

NPI Status: Active since June 13, 2024

Contact Information

194 E HIGHWAY 66 STE A
GALLUP, NM
ZIP 87301
Phone: (800) 737-0045
Fax: (800) 737-0012

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Complete NPI Dataset

This page contains the complete raw NPPES record for J&b Medical Supply Co Inc (NPI 1326881921), a durable medical equipment & medical supplies organization in Gallup, NM. All 28 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.

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Registry File Document Utilities
NPI: 1326881921
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: Not available
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business Name: J&B MEDICAL SUPPLY CO INC
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 50496 PONTIAC TRL
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City Name: WIXOM
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: MI
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 483932088
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider Business Mailing Address Telephone Number: 8007370045
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number: 8007370012
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Provider First Line Business Practice Location Address: 194 E HIGHWAY 66 STE A
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: GALLUP
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NM
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 873016232
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 8007370045
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 8007370012
The fax number associated with the location address of the provider being identified.
Authorized Official Last Name: SHAYA
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: JULIAN
The first name of the authorized official.
Authorized Official Title or Position: EXECUTIVE VICE PRESIDENT
The title or position of the authorized official.
Authorized Official Telephone Number: 8007370045
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 332B00000X
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Is Organization Subpart: N
Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
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