Healthcare Provider Details

I. General information

NPI: 1225729510
Provider Name (Legal Business Name): JONES MEDICAL SUPPLY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 05/17/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4177 MONTGOMERY HWY STE 5
DOTHAN AL
36303-1588
US

IV. Provider business mailing address

519 S BRUNDIDGE ST STE A
TROY AL
36081-3379
US

V. Phone/Fax

Practice location:
  • Phone: 334-305-3199
  • Fax: 334-305-3198
Mailing address:
  • Phone: 334-566-1002
  • Fax: 334-566-1003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier51527525
Identifier TypeOTHER
Identifier StateAL
Identifier IssuerBCBS OF AL

VIII. Authorized Official

Name: JASON C. JONES
Title or Position: PRESIDENT
Credential:
Phone: 334-566-1002