OrganizationJak Enterprises Inc(<Unavail>)Durable Medical Equipment & Medical SuppliesSuppliersPractice Address4032 46th Ave, Rock Island, IL 61201-7164(309) 786-9734(309) 693-9540PECOS EnrollmentBased on the most recent information from CMS, provider Jak Enterprises Inc 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 2 days ago.Profile DetailsProvider ID1790723542Provider TypeOrganizationFull NameJak Enterprises IncOther Name<Unavail>SubpartNoEnumeration Date6/3/2006Last Updated7/17/2024Contact InformationPractice LocationPractice Address4032 46th Ave, Rock Island, IL 61201-7164Phone(309) 786-9734Fax(309) 786-9790Mailing LocationMailing Address8309 N Knoxville Ave, Peoria, IL 61615-2170Phone(309) 693-9540Fax(309) 693-9542Authorized OfficialNameHall, Diana J (President)Phone(309) 693-9540Provider TaxonomiesCodeDescriptionLicenseCode332B00000XPrimaryDescriptionDurable Medical Equipment & Medical SuppliesSuppliersLicenseUnlisted IssuerCode152W00000XDescriptionOptometristEye and Vision Services ProvidersLicenseUnlisted Issuer