Provider Demographics
NPI:1235803370
Name:JONES COUNTY MEDICAL SUPPLIES, INC
Entity Type:Organization
Organization Name:JONES COUNTY MEDICAL SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:E
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-426-2574
Mailing Address - Street 1:PO BOX 23
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39441-0023
Mailing Address - Country:US
Mailing Address - Phone:601-426-2574
Mailing Address - Fax:601-518-6798
Practice Address - Street 1:9095 HIGHWAY 49
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-4319
Practice Address - Country:US
Practice Address - Phone:228-241-2100
Practice Address - Fax:228-241-2101
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JONES COUNTY MEDICAL SUPPLIES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies