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General NPI Number Information
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NPI Number | 1467415414
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Entity Type | Organization
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Legal Business Name | JONES COUNTY MEDICAL SUPPLIES, INC
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 1301 S 28TH AVE
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City | HATTIESBURG
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State | MS
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Zip | 39402-3106
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Country | US
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Telephone | 601-296-6000
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Fax | 601-296-2020
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Provider Business Mailing Address
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Address Line | PO BOX 23
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City | LAUREL
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State | MS
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Zip | 39441-0023
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Country | US
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Telephone | 601-296-6000
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Fax | 601-296-2020
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Authorized Official
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Title or Position | CEO
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Name | MR. CLAYTON E JOHNSON
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Credential |
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Telephone | 601-296-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 04318/11.1
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License Number State | MS
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