Jack City, Llc
Durable Medical Equipment & Medical Supplies
30 Center St, Watertown
Massachusetts, 02472-4018
617-393-1709 617-754-6420
Jack City, Llc is a Durable Medical Equipment & Medical Supplies in Watertown, Massachusetts. It is located at 30 Center St, Watertown and it's customer support contact number is 617-393-1709. The authorized person of Jack City, Llc is Codey Gillum, PA-C who is Ceo of this DME and his contact number is 617-754-5000. Jack City, Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Jack City, Llc is 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.
DME Supplier Details:
Jack City, Llc type, location, contact phone number and fax are as below. Patients can directly walkin or can call on the below given customer support phone number for enquiries.
| Name: | Jack City, Llc |
| Type: | Durable Medical Equipment & Medical Supplies |
| Location: | 30 Center St, Watertown,
Massachusetts, 02472-4018 |
| Phone: | 617-393-1709 |
| Fax: | 617-754-6420 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this supplier is as below. Person's position and contact details are also mentioned below.
| Name: | Codey Gillum |
| Credentials: | PA-C |
| Position: | Ceo |
| Contact Number: | 617-754-5000 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given supplier are as mentioned below.
| NPI Number: | 1376002931 |
| NPI Enumeration Date: | 13 Mar, 2019 |
| NPI Last Update On: | 15 Jan, 2026 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jack City, Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Durable Medical Equipment & Medical Supplies | | | Primary | |
| Surgical Technologist | | | Secondary | |
Medicare Enrollment:
Jack City, Llc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 2769716679 | O20190626003690 | Jack City Llc | DME SUPPLIER - PHYSICIAN - UNKNOWN PHYSICIAN SPECIALTY |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 30 Center St,
Watertown, Massachusetts |
| Zip: | 02472-4018 |
| Phone Number: | 617-393-1709 |
| Fax Number: | 617-754-6420 |
Patients can reach Jack City, Llc at
30 Center St, Watertown, Massachusetts or can
call on customer care at 617-393-1709.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 February, 2026.