Basic Information
| Provider Information | |||||||||
| NPI: | 1457723496 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | JSQUARED MEDICAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 34120 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895334120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757475050 | ||||||||
| FaxNumber: | 7757475005 | ||||||||
| Practice Location | |||||||||
| Address1: | 580 E PLUMB LN | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895023504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757475050 | ||||||||
| FaxNumber: | 7757475005 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2015 | ||||||||
| LastUpdateDate: | 10/29/2015 | ||||||||
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| AuthorizedOfficialLastName: | HORTON | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7757475050 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | TX | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.