{"npi":"1619960663","type":"NPI-2","status":"active","name":{"display":"J Q Medical Supply, LLC","other":[],"organization_name":"J Q MEDICAL SUPPLY, LLC","authorised_official":"Ryan Schorr"},"specialty":{"primary_taxonomy":"332B00000X","primary_taxonomy_description":"Durable Medical Equipment & Medical Supplies","slug":"durable-medical-equipment-medical-supplies","schema_org_specialty":null,"all":[{"code":"332B00000X","description":"Durable Medical Equipment & Medical Supplies","primary":true,"state":"UT","license":"E42635"}]},"addresses":[{"purpose":"LOCATION","street_1":"6910 S HIGHLAND DR STE 4","city":"SALT LAKE CITY","state":"UT","postal_code":"841213087","country_code":"US","phone":"8002316820","fax":"8018803634"},{"purpose":"MAILING","street_1":"1225 E FORT UNION BLVD STE 310","city":"MIDVALE","state":"UT","postal_code":"840471883","country_code":"US","phone":"8019428582","fax":"8018803634"}],"license":{"state":"UT","number":"E42635"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"3012912","state":"UT","issuer":null}],"pecos":{"enrolled_at":"2026-07-01T15:01:53.235063+00:00","enrollments":[{"enrlmt_id":"O20100930015145","type_code":"30-54","type_desc":"DME SUPPLIER - MEDICAL SUPPLY COMPANY","state":"UT","pac_id":"9234259771"}]},"enumeration_date":"2005-08-24","last_updated":"2026-03-25","_meta":{"source":"NPPES","snapshot_date":"2026-03-25","doc_url":"https://findmynpi.com/api"}}