Basic Information
Provider Information
NPI: 1245511633
EntityType: 2
ReplacementNPI:  
OrganizationName: ARJ MEDICAL INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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Mailing Information
Address1: 2980 N BEVERLY GLEN CIR
Address2: SUITE 301
City: LOS ANGELES
State: CA
PostalCode: 900771726
CountryCode: US
TelephoneNumber: 3104749809
FaxNumber:  
Practice Location
Address1: 1902 ROYALTY DR
Address2: SUITE 120
City: POMONA
State: CA
PostalCode: 917673030
CountryCode: US
TelephoneNumber: 9096225600
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/30/2011
LastUpdateDate: 08/30/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: JARMINSKI
AuthorizedOfficialFirstName: ANDREW
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 9096225600
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: ARJ MEDICAL INC.
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332900000X  Y SuppliersNon-Pharmacy Dispensing Site 

No ID Information.


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