Jonathan Beasley Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

114683 Issued in AL

Legal business name

JONATHAN BEASLEY PHARMACY INC

Doing business as

Beasley's Pharmacy

Practice address

170 5TH St SW
Vernon, AL 35592-5215

Phone

(205) 695-0144

Fax

(205) 695-0139

NPI assigned

Dec 16, 2016

Last updated

Apr 24, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jonathan BeasleyNPI 1275825861

Title

Owner

Phone

(205) 695-0144

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Beasley's Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Jonathan Beasley Pharmacy Inc

  dba Sullient Drug

  • Pharmacy
  • Sulligent, AL
  • NPI 1447800198

  0648526848

  Same PAC ID

Tax ID family

Jonathan Beasley Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jonathan Beasley Pharmacy Inc

  dba Sullient Drug

  • Pharmacy
  • Sulligent, AL
  • NPI 1447800198
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Jonathan Beasley Pharmacy Inc

  dba Sullient Drug

  • Pharmacy
  • Sulligent, AL
  • NPI 1447800198
  NPPES parent name

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.

• Jonathan Beasley

  • Pharmacist
  • Vernon, AL
  • NPI 1275825861
  NPD Authorized official

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

{
    "created_epoch": "1481846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492992000000",
    "number": "1073057535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 456",
            "city": "VERNON",
            "state": "AL",
            "postal_code": "355920456",
            "telephone_number": "205-695-0144",
            "fax_number": "205-695-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 5TH ST SW",
            "city": "VERNON",
            "state": "AL",
            "postal_code": "355925215",
            "telephone_number": "205-695-0144",
            "fax_number": "205-695-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN BEASLEY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-16",
        "last_updated": "2017-04-24",
        "status": "A",
        "authorized_official_last_name": "BEASLEY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-695-0144"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "114683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167011",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196440",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beasley's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Generations of Vernon, LLC
• Generations Professional Services, LLC
• Angela Lea Carroll Glasgow, CRNP
• Hospital Discount Apothecary, Inc
• Innerfit of Tuscaloosa, Inc. (Innerfit of Vernon)
• Jamie Perkins Kendrick, FNP-C
• Nancy R Kennedy, LPC
• Kelly Kinard, BSN, RN, CBS
• Andrew Franklin Kizzire, MA, LPC, NCC
• Cindy Cates Lake, CRNP

• Community/Retail Pharmacy in Vernon, AL
• Providers in Vernon, AL by specialty
• Community/Retail Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.