JEA OPTICAL LLC (NPI# 1023572823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023572823 |
| Entity Type | Organization |
| Organization Name | JEA OPTICAL LLC |
| Practice Address |
102 Clinton Pkwy Clinton MS 39056-4730 |
| Mailing Address |
1200 N State St Ste 330 Jackson MS 39202-2027 |
| Practice Telephone | 6019249750 |
| Practice Fax Number | 6019259791 |
| 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 |
| 1215491014 | Jea Optical LLC | Durable Medical Equipment & Medical Supplies | 401 Baptist Dr Ste 201, Madison, MS 39110-2009 | 2019-01-25 |
| Street Address |
102 CLINTON PKWY |
| City | CLINTON |
| State | MS |
| Zip Code | 39056-4730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184671489 | Jackson Eye Associates Pllc | Clinic/Center | 102 Clinton Pkwy, Third Floor, Clinton, MS 39056-4730 | 2006-05-30 |
| 1831137009 | Jackson Eye Associates Pllc | Durable Medical Equipment & Medical Supplies | 102 Clinton Pkwy, Fl 3, Clinton, MS 39056-4730 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376012724 | John Melvin Goolsby Jr. | Dentist | 457 Highway 80 East, Clinton, MS 39056 | 2018-11-15 |
| 1225534530 | Magnolia Allergy Clinic LLC | Internal Medicine | 402 Cynthia St Ste E, Clinton, MS 39056 | 2018-04-04 |
| 1578093704 | Melinda A Weisenberger | Specialist/Technologist | 4600 W Northside Drive, Clinton, MS 39056 | 2017-06-20 |
| 1962859702 | Telehealthone, LLC | Nurse Practitioner | 200 Clinton Plaza, Clinton, MS 39056 | 2016-05-23 |
| 1841686581 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 132 Fairmont Street, Suite B, Clinton, MS 39056 | 2015-04-09 |
| 1023412822 | Rebecca Brooks Prewitt | Social Worker | 130 B Fairmont Street, Clinton, MS 39056 | 2014-10-22 |
| 1396184149 | Robert Joseph Hargis | Urology | 116 Afton Way, Clinton, MS 39056 | 2013-06-14 |
| 1750626321 | Clinton Dental Care, Inc. | Dentist | 736 Clinton Pkwy, Clinton, MS 39056 | 2012-12-07 |
| 1922394469 | Daphenia C. Knight Starling | Nurse Practitioner | Clinton Healthcare, 1251 Pinehaven Rd, Clinton, MS 39056 | 2011-06-23 |
| 1134443385 | Gwendolyn Coleman Garror | Pharmacist | 132 Fairmount Drive, Clinton, MS 39056 | 2010-03-17 |
| Find all providers in zip 39056 | ||||
| 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 |
|---|---|---|---|---|
| 1154942654 | Priority Home Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 517 S 30th St, Clinton, OK 73601-3632 | 2020-05-06 |
| 1952864266 | Roy C Patton | Durable Medical Equipment & Medical Supplies | 305 Clinton Blvd, Clinton, MS 39056-5217 | 2019-04-12 |
| 1811427214 | Pause The Pain | Durable Medical Equipment & Medical Supplies | 637 N 1260 W, Clinton, UT 84015-9305 | 2017-06-18 |
| 1730538885 | Medworx Home Medical Supplies LLC | Durable Medical Equipment & Medical Supplies | 988 S Broad St, Clinton, SC 29325-2866 | 2016-06-09 |
| 1386011278 | St. Regis Medical Equipment Corp. | Durable Medical Equipment & Medical Supplies | 8195 Seneca Tpke, Clinton, NY 13323-1100 | 2015-08-26 |
| 1841686581 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 132 Fairmont Street, Suite B, Clinton, MS 39056 | 2015-04-09 |
| 1770826158 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 801 Highway 80 E, Clinton, MS 39056-5252 | 2013-04-03 |
| 1649512260 | Recovery Sports Inc | Durable Medical Equipment & Medical Supplies | 143 Navajo Cir, Clinton, MS 39056-3110 | 2013-03-21 |
| 1407196272 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1501 E Ohio St, Clinton, MO 64735 | 2013-02-15 |
| 1235483777 | Excel Health Systems LLC | Durable Medical Equipment & Medical Supplies | 10735 Roosevelt Street, Clinton, LA 70722 | 2012-11-06 |
| Find all providers in CLINTON | ||||
Please comment or provide details below to improve the information on JEA OPTICAL LLC.
| 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.