Jamestown Valu-Rite Pharmacy Inc
Organization Active NPI Community/Retail Pharmacy · Jamestown, KY
NPI 1164512802 · NPPES record last updated Oct 10, 2014
Key facts
- NPI
- 1164512802
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- P00535 (KY)
- Legal business name
- JAMESTOWN VALU-RITE PHARMACY INC
- Practice address
- 1417 N Main St Ste a
Ste a
Jamestown, KY 42629-2411 - Phone
- (270) 343-4443
- Fax
- (270) 343-4481
- NPI assigned
- Oct 13, 2006
- Organization subpart
- No
Authorized official
- Name
- Jeffery Warner
- Title
- Owner
- Phone
- (270) 343-4443
Practitioners 2
-
Michelle Egnew Carnes, PHARMD
-
Jeffrey Louis Warner, RPH.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930005854 | KY | DME Supplier - Pharmacy | 9537287180 | Practice locations: Jamestown, KY |
| O20101029000084 | KY | Part B Supplier - Mass Immunization (Roster Biller Only) | 9537287180 | Practice locations: Jamestown, KY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | P00535 | KY | Yes |
Addresses
Primary practice location
1417 N Main St Ste a
Ste a
Jamestown, KY 42629-2411
Mailing address
PO Box 499
Jamestown, KY 42629-0499
Phone (270) 343-4443
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2030203 | Other | PK | |
| 54006313 | Medicaid | KY |
Other names
- JAMESTOWN PHARMACY
Other providers in Jamestown, KY
- Indigo Wellness
- Amy Irvin
- Jamestown Healthcare Clinic LLC
- Jamestown Healthcare Clinic, LLC
- Jamestown Valu-Rite Pharmacy
- Jamestown Valu-Rite Pharmacy Inc
- Meghan Jasper
- Elizabeth Johnson
- Thomas Dwayne Johnson
- Stephanie R Jones
All providers in Jamestown, KY · Community/Retail Pharmacy in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.