Provider Demographics
NPI:1801261177
Name:JONES COMMUNITY HEALTH CENTER, LLC
Entity type:Organization
Organization Name:JONES COMMUNITY HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ORETHA
Authorized Official - Middle Name:D
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:850-694-9864
Mailing Address - Street 1:115 SHADOW POND
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-6416
Mailing Address - Country:US
Mailing Address - Phone:850-694-9864
Mailing Address - Fax:
Practice Address - Street 1:115 SHADOW POND
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021
Practice Address - Country:US
Practice Address - Phone:850-694-9864
Practice Address - Fax:850-270-2452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-11
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3298622261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1801261177OtherNPI
FL018872300Medicaid