Individual provider · Type 1 NPI
Andre Wayne Jackson, OTHER
Durable Medical Equipment & Medical Supplies · Richmond, CA
NPI number
1174452387
Active
Practice location
2930 Hilltop Mall Rd Ste B
Richmond, CA 94806-2197
Fax (866) 665-8815
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Durable Medical Equipment & Medical Supplies Primary | 332B00000X | 101135 (CA) |
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.
Other durable medical equipment & medical supplies providers in Richmond
About NPI 1174452387
Andre Wayne Jackson, OTHER's National Provider Identifier is 1174452387, issued on May 14, 2026. The primary taxonomy on file is Durable Medical Equipment & Medical Supplies (332B00000X), and the practice location is in Richmond, CA. The record was last updated on May 14, 2026.