Provider Demographics
NPI:1225689383
Name:JMS HOME MEDICAL SUPPLY, LLC
Entity Type:Organization
Organization Name:JMS HOME MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:T
Authorized Official - Last Name:WAGGONER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-569-2311
Mailing Address - Street 1:5365 S STATE HIGHWAY 37
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:TX
Mailing Address - Zip Code:75773-6919
Mailing Address - Country:US
Mailing Address - Phone:903-569-2311
Mailing Address - Fax:903-569-8296
Practice Address - Street 1:5365 S STATE HIGHWAY 37
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:TX
Practice Address - Zip Code:75773-6919
Practice Address - Country:US
Practice Address - Phone:903-569-2311
Practice Address - Fax:903-569-8296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies