Individual ProviderJacob Mark JamesStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address18701 N 67th Ave, Glendale, AZ 85308-7100(877) 934-9355(801) 673-7413PECOS EnrollmentBased on the most recent information from CMS, provider Jacob Mark James does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 8 days ago.Profile DetailsProvider ID1669177143Provider TypeIndividualFull NameJames, Jacob MarkCredentialDOGenderMaleSole ProprietorYesEnumeration Date4/3/2023Last Updated4/3/2023Contact InformationPractice LocationPractice Address18701 N 67th Ave, Glendale, AZ 85308-7100Phone(877) 934-9355FaxUnlisted FaxMailing LocationMailing Address1226 Millbridge Ln, West Bountiful, UT 84087-1418Phone(801) 673-7413FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer