JACKSON MEDICAL SUPPLY INC (NPI# 1386974491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386974491 |
| Entity Type | Organization |
| Organization Name | JACKSON MEDICAL SUPPLY INC |
| Practice Address |
506 Main St Vacaville CA 95688-3922 |
| Practice Telephone | 7074467014 |
| Practice Fax Number | 7074461871 |
| Mailing Telephone | 7074467014 |
| Mailing Fax Number | 7074461871 |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2010-06-29 |
| Authorized Official Name | MS. WENDY ANN WIGMORE (OWNER) |
| Authorized Official Telephone | 7074467014 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 103834 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 03183F | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104136126 | Jackson Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 604 Main St, Woodland, CA 95695-3405 | 2010-10-08 |
| 1578873592 | Jackson Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 480 Redwood St, # 44, Vallejo, CA 94590-2958 | 2010-10-08 |
| 1386813806 | Jackson Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 2147 Henry Hill Dr, Ste 109, Jackson, MS 39204-2001 | 2008-02-28 |
| Street Address |
506 MAIN ST |
| City | VACAVILLE |
| State | CA |
| Zip Code | 95688-3922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245230424 | Wendy Wigmore | Durable Medical Equipment & Medical Supplies | 506 Main St, Vacaville, CA 95688-3912 | 2005-07-28 |
| 1104050491 | Wendy Ann Wigmore | Durable Medical Equipment & Medical Supplies | 506 Main St, Vacaville, CA 95688-3922 | 2009-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851917165 | Katelyn Renee Watson | Military Health Care Provider | 101 Bodin Drive, Bldg 777, Fairfield, CA 95688 | 2020-06-23 |
| 1043842917 | Dr. Page Hudson Dental Corporation | Dentist | 1671 East Monte Vista Ave, Suite 200, Vacaville, CA 95688 | 2020-02-10 |
| 1356981534 | Demi Renae Holder | Behavior Technician | 6801 Leisure Town Rd Apt. 153, Vacaville, CA 95688 | 2020-01-15 |
| 1073089074 | Sukhdeep Kaur | Nurse Practitioner | 679 E Monte Vista Ave #140, Vacaville, CA 95688 | 2018-10-17 |
| 1114419553 | Sharlie Mccurry | Behavior Technician | 3333 Vaca Valley Pkwy, Suite 900, Vacaville, CA 95688 | 2018-06-01 |
| 1720577307 | Ana Lynch | Behavioral Analyst | 250 Grape St, Vacaville, CA 95688 | 2018-05-09 |
| 1508382011 | Esther's Empowerment Leadership Institute, LLC | Health Educator | 227 Fairoaks Drive, Vacaville, CA 95688 | 2017-08-16 |
| 1023534807 | Jean Allyson Garcia | Counselor | 1286 Callen Street, Vacaville, CA 95688 | 2017-08-14 |
| 1437692043 | Ahmed Abdi Ali | Pharmacist | 1 Quality Drive, Mob-b 1st Flr, 24 Hrs Pharmacy, Vacaville, CA 95688 | 2016-11-30 |
| 1275961807 | Laura Hitt | Dietitian, Registered | 107 Blackwood Ct, Vacaville, CA 95688 | 2013-10-16 |
| Find all providers in zip 95688 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508338054 | Integrative Foot and Ankle Center | Durable Medical Equipment & Medical Supplies | 600 Nut Tree Rd Ste 210, Vacaville, CA 95687 | 2018-12-21 |
| 1215374913 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 2050 Nut Tree Rd, Vacaville, CA 95687-7108 | 2013-06-04 |
| 1720424799 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 941 Alamo Dr, Vacaville, CA 95687-5601 | 2013-05-17 |
| 1730358276 | Miracco Medical LLC | Durable Medical Equipment & Medical Supplies | 859 Cotting Ct Ste B, Vacaville, CA 95688-9354 | 2008-02-28 |
| 1598842916 | Rem Medical | Durable Medical Equipment & Medical Supplies | 490 Merchant St, Suite 101, Vacaville, CA 95688-4551 | 2006-11-01 |
| 1487763835 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 2050 Nut Tree Road, Elmira Square, Vacaville, CA 95687-7108 | 2006-08-30 |
| 1144235425 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2010 Alamo Dr, Vacaville, CA 95687-6289 | 2006-07-29 |
| 1437171048 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 3000 Harbison Dr, Vacaville, CA 95687-3909 | 2006-07-24 |
| 1487671731 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 1500 Helen Power Dr, Vacaville, CA 95687-3506 | 2006-07-16 |
| 1760409007 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 1501 Helen Power Dr, Vacaville, CA 95687-3351 | 2006-07-16 |
| Find all providers in VACAVILLE | ||||
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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.