JTJ MEDICAL SUPPLY, INC. (NPI# 1134770753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134770753 |
| Entity Type | Organization |
| Organization Name | JTJ MEDICAL SUPPLY, INC. |
| Practice Address |
1911 Hampton St Columbia SC 29201-3535 |
| Mailing Address |
2692 Oak Ridge Ct Fort Myers FL 33901-9351 |
| Practice Telephone | 8009392022 |
| Practice Fax Number | 8555230910 |
| Mailing Telephone | 2399399226 |
| Mailing Fax Number | 8555230910 |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2019-09-25 |
| Authorized Official Name | MARK JOHN THEOBALD (CEO) |
| Authorized Official Telephone | 2399399226 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Mail-Meds Clinical Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215578901 | Jtj Medical Supply, Inc. | Pharmacy | 1001 Monticello Ave, Norfolk, VA 23510-2564 | 2019-10-03 |
| 1972983880 | Jtj Medical Supply, Inc. | Pharmacy | 1435 Dunn Ave Ste 102, Daytona Beach, FL 32114-1434 | 2015-06-05 |
| 1558369140 | Jtj Medical Supply, Inc. | Pharmacy | 2692 Oak Ridge Ct, Fort Myers, FL 33901-9351 | 2005-07-08 |
| 1497381511 | Jtj Medical Supply, Inc. | Pharmacy | 4350 N 19th Ave Ste 2, Phoenix, AZ 85015-4602 | 2020-03-20 |
| 1972141166 | Jtj Medical Supply, Inc. | Pharmacy | 1301 W Colonial Dr, Orlando, FL 32804-7133 | 2019-12-18 |
| 1427578731 | Jtj Medical Supply, Inc. | Pharmacy | 2200 S Monroe St, Tallahassee, FL 32301-6303 | 2017-06-27 |
| Street Address |
1911 HAMPTON ST |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29201-3535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700882776 | Robert B. Borucki | Family Medicine | 1911 Hampton St, Columbia, SC 29201 | 2005-06-24 |
| 1467684522 | Donna Lynn Crocker | Registered Nurse | 1911 Hampton St, Columbia, SC 29201-3535 | 2009-08-21 |
| 1982673836 | Comprehensive Care LLC | Clinic/Center | 1911 Hampton St, Columbia, SC 29201-3535 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366049421 | Souzan Moslehshirazi | Behavior Technician | 1320 Main Street Suite 300, Colombia, SC 29201 | 2020-10-02 |
| 1295353936 | Kayla Faylyn Nicole Mckenzie | Specialist/Technologist | 1905 Southern Drive, Unit 1905a, Columbia, SC 29201 | 2020-07-09 |
| 1548887128 | Casania's Caring Hands,llc | Home Health Aide | 1113 Belleview Street, 105, Columbia, SC 29201 | 2020-06-30 |
| 1639719909 | Benjamin Clark Watson | Acupuncturist | 1825 Sumter St., Columbia, SC 29201 | 2020-01-14 |
| 1588217574 | Aneika Daley | Specialist/Technologist | 1211 Wheat St, Columbia, SC 29201 | 2019-07-19 |
| 1447803531 | Gillian Taylor Shaughnessy | Specialist/Technologist | 147 South Marion St, Columbia, SC 29201 | 2019-07-18 |
| 1417417619 | Maria Nelson | Behavior Technician | 320 Main St Suite 300, Columbia, SC 29201 | 2019-03-22 |
| 1679041297 | Nathaniel Carl Stocker | Nurse Practitioner | 1614 Main Street, Suite C, Sc House Calls Inc, Columbia, SC 29201 | 2018-11-13 |
| 1558852855 | The Practice | Family Medicine | 1910 Gregg Street, Columbia, SC 29201 | 2018-05-22 |
| 1871095836 | Kadesjah Samuels | Behavior Technician | 1320 Main Street, Suite 300, Columbia, SC 29201 | 2018-03-06 |
| Find all providers in zip 29201 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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|---|---|---|---|---|
| 1699374629 | Curators of The University of Missouri | Pharmacy | 7115 East St. Charles Road, Columbia, MO 65202 | 2020-10-21 |
| 1821695735 | Msm Rx LLC | Pharmacy | 6323b N Main St, Columbia, SC 29203-4733 | 2020-10-04 |
| 1396355426 | Mdk Health | Pharmacy | 3985 Columbia Ave Unit 2, Columbia, PA 17512-9003 | 2020-08-04 |
| 1851913974 | Ebenezer Health Investors Inc | Pharmacy | 3217 Devine St, Columbia, SC 29205-1847 | 2020-05-12 |
| 1205492345 | Denise Jorene Wilkinson | Pharmacy | 108 Park Terrace Dr, Columbia, SC 29212-3713 | 2019-05-14 |
| 1093379521 | Qwik-med Pharmacy LLC | Pharmacy | 369 Locust St Rear, Columbia, PA 17512-1383 | 2019-04-30 |
| 1932682960 | Columbia Rx LLC | Pharmacy | 10798 Hickory Ridge Rd Ste A, Columbia, MD 21044-3646 | 2018-09-14 |
| 1558756072 | Gustafsons Apothecary LLC | Pharmacy | 110a Clemson Rd, Columbia, SC 29229-6544 | 2015-04-01 |
| 1740526276 | Missouri Cvs Pharmacy LLC | Pharmacy | 2400 Bernadette Dr, Columbia, MO 65203-4616 | 2013-01-03 |
| 1255680138 | Cvs Pharmacy | Pharmacy | 900 Assembly Street, Columbia, SC 29201-3938 | 2012-09-06 |
| Find all providers in COLUMBIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.