MEDICARE: JONES COUNTY MEDICAL SUPPLIES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	05998/11.1	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	823006	OTHER	MS	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1639133994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONES COUNTY MEDICAL SUPPLIES, INC

Provider Business Mailing Address
First Line	:	PO BOX 23
Second Line	:
City	:	LAUREL
State	:	MS
Zip	:	39441-0023
Country	:	US
Telephone Number	:	601-426-2574
Fax Number	:	601-649-3185

Provider Business Practice Location Address
First Line	:	205 MAIN ST
Second Line	:
City	:	COLLINS
State	:	MS
Zip	:	39428
Country	:	US
Telephone Number	:	601-765-3277
Fax Number	:	601-765-3270

Authorized Official
Title or Position	:	CEO
Name	:	MR. CLAYTON E JOHNSON
Credential	:
Telephone Number	:	601-765-3277

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	05/08/2026

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