MEDICARE: JONES COUNTY NURSING HOME LLC

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	314000000X	Skilled Nursing Facility	1-084-1787	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51003876 001	OTHER		BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043253172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONES COUNTY NURSING HOME LLC

Provider Business Mailing Address
First Line	:	PO BOX 175
Second Line	:
City	:	GRAY
State	:	GA
Zip	:	31032-0175
Country	:	US
Telephone Number	:	478-986-3151
Fax Number	:	478-986-1381

Provider Business Practice Location Address
First Line	:	302 GEORGIA 18 E
Second Line	:
City	:	GRAY
State	:	GA
Zip	:	31032
Country	:	US
Telephone Number	:	478-986-3151
Fax Number	:	478-986-1381

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	VALERIE LAW
Credential	:
Telephone Number	:	478-986-3151

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	02/12/2026

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Directions to “JONES COUNTY NURSING HOME LLC ” Practice Location

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