Organization Active NPI

K and C Pharmacies Inc

Doing business as Jefferson Drugs

  • Community/Retail Pharmacy
  • Jefferson, GA
National Provider Identifier
1003979626
Registry record updated Dec 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE009101 Issued in GA
Legal business name
K AND C PHARMACIES INC
Doing business as
Jefferson Drugs
Practice address
23 Lee St
Jefferson, GA 30549-1345
Phone
(706) 367-5221
Fax
(706) 367-4036
NPI assigned
Dec 18, 2006
Last updated
Dec 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2015

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

Authorized official

Name
Keith Chapman, RPHNPI 1558326561
Title
President
Phone
(706) 367-5221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHRE009101 GA Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

23 Lee St
Jefferson, GA 30549-1345

Mailing address

23 Lee St
Jefferson, GA 30549-1345
Phone (706) 367-5221

Other identifiers 2

IdentifierTypeStateIssuer
357340127AMedicaidGA
2016463OtherPK

Other names 1

  • JEFFERSON DRUGS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20091130000125 GA Part B Supplier - Mass Immunization (Roster Biller Only) 8527107820 Practice locations: Jefferson, GA
O20100930047263 GA DME Supplier - PharmacyDME Supplier - Oxygen & Equipment 8527107820 Practice locations: Jefferson, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2184309Jefferson Drugs23 Lee Street, Jefferson, GA 30549Certificate of waiverMay 18, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
K and C Pharmacies Inc23 Lee St, Jefferson, GA 30549-1345(706) 367-5221 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Does not accept assignmentParticipating since Sep 2, 2009

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449446400000",
    "number": "1003979626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 LEE ST",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305491345",
            "telephone_number": "706-367-5221",
            "fax_number": "706-367-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 LEE ST",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305491345",
            "telephone_number": "706-367-5221",
            "fax_number": "706-367-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K AND C PHARMACIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2015-12-07",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-367-5221",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009101",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "357340127A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2016463",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JEFFERSON DRUGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.