Andre Wayne Jackson, OTHER
Andre Wayne Jackson, OTHER is a Durable Medical Equipment & Medical Supplies in Richmond, California. Practices as a sole proprietor. Licensed in California.
- Licensed in
- CA
- In the registry since
- 2026
Practice location Address checks out
2930 Hilltop Mall Rd Ste BRichmond, CA 94806-2197
Phone: (510) 222-1075
Fax: (866) 665-8815
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Specialties & licences
| Durable Medical Equipment & Medical Supplies (primary) | Taxonomy 332B00000X · Licence 101135 (CA) |
|---|
Record details
| NPI number | 1174452387 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | OTHER |
| Sole proprietor | Yes |
| NPI enumerated | May 14, 2026 |
| Last updated in NPPES | May 14, 2026 |
| Certification date | May 14, 2026 |
| Mailing address | 2930 Hilltop Mall Rd Ste B, Richmond, CA 94806-2197 |
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