JEA OPTICAL LLC (NPI# 1215491014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215491014 |
| Entity Type | Organization |
| Organization Name | JEA OPTICAL LLC |
| Practice Address |
401 Baptist Dr Ste 201 Madison MS 39110-2009 |
| Mailing Address |
1200 N State St Ste 330 Jackson MS 39202-2027 |
| Practice Telephone | 6018532020 |
| Practice Fax Number | 6018532728 |
| Mailing Telephone | 6013520274 |
| Mailing Fax Number | 6017145110 |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2019-01-25 |
| Authorized Official Name | ROBERT AMORY MALLETTE (MANAGING PARTNER) |
| Authorized Official Telephone | 6013532020 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720542855 | Jea Optical LLC | Durable Medical Equipment & Medical Supplies | 1200 N State St Ste 110, Jackson, MS 39202-2027 | 2019-01-23 |
| 1023572823 | Jea Optical LLC | Durable Medical Equipment & Medical Supplies | 102 Clinton Pkwy, Clinton, MS 39056-4730 | 2019-01-25 |
| Street Address |
401 BAPTIST DR STE 201 |
| City | MADISON |
| State | MS |
| Zip Code | 39110-2009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942206149 | Philip C Smith | Ophthalmology | 401 Baptist Dr Ste 201, Madison, MS 39110 | 2005-06-22 |
| 1003170036 | Alexander Chapman Whittington | Internal Medicine | 401 Baptist Dr Ste 201, Madison, MS 39110-2009 | 2012-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134784689 | Therapy South - Gluckstadt LLC | Physical Therapist | 1716 Us 51, Ste N, Madison, MS 39110 | 2019-05-09 |
| 1871054098 | Summit Medical Solutions | Durable Medical Equipment & Medical Supplies | 107 Azalea Street, Madison, MS 39110 | 2019-03-29 |
| 1912488198 | Madison Medical Compounding Pharmacy | Pharmacy | 111 Fountains Blvd. Building B Ste. A, Madison, MS 39110 | 2018-08-24 |
| 1679061469 | Nuvena Vein Clinic | Anesthesiology | 120 Fountains Blvd, Madison, MS 39110 | 2018-04-26 |
| 1467960484 | Brick City Drugs, LLC | Durable Medical Equipment & Medical Supplies | 159 Fountains Blvd, Madison, MS 39110 | 2018-01-11 |
| 1093227589 | Hannah Monk Hawthorne | Counselor | 930 Ebenezer Blvd., Suite D, Madisin, MS 39110 | 2017-10-25 |
| 1548786650 | Kimberly Allen | Pharmacist | 1100 Us- 51, Madison, MS 39110 | 2017-08-21 |
| 1891218186 | Delta Elizabeth Stark | Chiropractor | 1085 Gluckstadt Rd., Bld 300 Ste E, Madison, MS 39110 | 2017-07-19 |
| 1861914848 | Laura Hartlein | Dietitian, Registered | 200 Park Circle Dr. #2, Flowood, MS 39110 | 2017-07-12 |
| 1831620608 | Ona Irby | Occupational Therapist | 105 Munich Dr, Madison, MS 39110 | 2017-03-23 |
| Find all providers in zip 39110 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376180414 | United Medical Providers, Inc | Durable Medical Equipment & Medical Supplies | 600 Medical Park Dr Ste 115, Madison, TN 37115-4253 | 2019-12-09 |
| 1871054098 | Summit Medical Solutions | Durable Medical Equipment & Medical Supplies | 107 Azalea Street, Madison, MS 39110 | 2019-03-29 |
| 1174088983 | Publix Alabama LLC | Durable Medical Equipment & Medical Supplies | 7129 Wall Triana Highway, Madison, AL 35757 | 2019-02-06 |
| 1255818431 | Publix Alabama, LLC | Durable Medical Equipment & Medical Supplies | 350 Hughes Rd, Madison, AL 35758-1102 | 2018-07-20 |
| 1467960484 | Brick City Drugs, LLC | Durable Medical Equipment & Medical Supplies | 159 Fountains Blvd, Madison, MS 39110 | 2018-01-11 |
| 1891213476 | Mending Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 3111 E Washington Ave Ste 103, Madison, WI 53704-4330 | 2017-09-05 |
| 1114443892 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 432 S Park St, Madison, WI 53715-1618 | 2017-08-15 |
| 1912421520 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1770 Eatonton Rd, Madison, GA 30650-4638 | 2017-07-26 |
| 1548634611 | Total Healthcare Solutions LLC | Durable Medical Equipment & Medical Supplies | 421 Business Park Dr, Madison, MS 39110-9498 | 2015-11-30 |
| 1215308879 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 7520 Highway 72 W, Madison, AL 35758-9554 | 2015-10-08 |
| Find all providers in MADISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.