NPIMap

Organization Active NPI

Westside Pharmacy Inc

Doing business as Jaks Public Pharmacy

  • Pharmacy
  • Bowling Green, OH
National Provider Identifier
1013982446
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
WESTSIDE PHARMACY INC
Doing business as
Jaks Public Pharmacy
Practice address
970 W Wooster St
Suite #121
Bowling Green, OH 43402-2643
Phone
(419) 352-6423
Fax
(419) 353-8283
NPI assigned
Feb 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
James Lee Glassford, RPHNPI 1578538906
Title
Owner
Phone
(419) 352-6423

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X OH Primary

Addresses

Primary practice location

970 W Wooster St
Suite #121
Bowling Green, OH 43402-2643

Mailing address

970 W Wooster St
Suite #121
Bowling Green, OH 43402-2643
Phone (419) 352-6423

Other identifiers 1

IdentifierTypeStateIssuer
2018104MedicaidOH

Other names 1

  • JAKS PUBLIC PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

970 W Wooster St
Ste 121
Bowling Green, OH 43402
Phone (419) 352-6423

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013982446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 W WOOSTER ST",
            "address_2": "SUITE #121",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434022643",
            "telephone_number": "419-352-6423",
            "fax_number": "419-353-8283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 W WOOSTER ST",
            "address_2": "SUITE #121",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434022643",
            "telephone_number": "419-352-6423",
            "fax_number": "419-353-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GLASSFORD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-352-6423",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2018104",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JAKS PUBLIC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bowling Green, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.