Jacob Jones
Individual provider Active NPI Community/Retail Pharmacy · Amherst, VA
NPI 1245954148 · NPPES record last updated Oct 4, 2022
Key facts
- NPI
- 1245954148
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 0202219932 (VA)
- Practice address
- 112 S Main St
Amherst, VA 24521-3201 - Phone
- (434) 946-2702
- Fax
- (434) 946-0025
- NPI assigned
- Oct 4, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202219932 | VA | MD | Community/Retail Pharmacy |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 0202219932 | VA | Yes |
Addresses
Primary practice location
112 S Main St
Amherst, VA 24521-3201
Mailing address
PO Box 1017
Amherst, VA 24521-1017
Phone (434) 946-2702
Other providers in Amherst, VA
- Lisa Doss Houchens
- Dercilla Jackson
- Taylor Knight James
- Valerie Fay Jarboe
- Johnson Senior Center Inc
- Lakisha Jones
- Zachary Karnavas
- Susan Kaslo
- Joshua S Kerr
- Lee Tree, LLC
All providers in Amherst, VA · Community/Retail Pharmacy in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.