Your Medical Supply Co, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

YOUR MEDICAL SUPPLY CO, LLC

Practice address

19G E Lincoln Rd NE
Brookhaven, MS 39601-8757

Phone

(601) 265-2055

Fax

(601) 265-2257

NPI assigned

Feb 13, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jada Davis

Title

President

Phone

(601) 265-2055

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Sherwood Mobley, D.C.

  • Chiropractor
  • Brookhaven, MS
  • NPI 1457371395
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1063045409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19G E LINCOLN RD NE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396018757",
            "telephone_number": "601-265-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19G E LINCOLN RD NE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396018757",
            "telephone_number": "601-265-2055",
            "fax_number": "601-265-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR MEDICAL SUPPLY CO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-13",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JADA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-265-2055"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Leann Wilson, FNP-C
• Devon Brooke Winborne
• James E Wroten Jr., FNP
• Chad Yarborough, MA, MDIV, P-LPC
• Nebiyou Yifru, PHARMD

• Durable Medical Equipment & Medical Supplies in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.